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BOSTON MUTUAL LIFE INSURANCE COMPANY 120 Royal Street Canton, MA 02021 18006692668 Ext. 473 EVIDENCE OF INSURABILITY FORM FOR INSURANCE To be completed for all proposed insureds who are applying for

How to fill out evidence of insurability form

How to fill out evidence of insurability form:

1. Start by carefully reading the instructions provided with the form. Familiarize yourself with the requirements and any specific details mentioned.
2. Provide personal information such as your full name, date of birth, and contact details in the appropriate sections of the form.
3. Indicate the type of insurance for which you are seeking evidence of insurability, such as life insurance or disability insurance.
4. Answer questions regarding your health history and any pre-existing medical conditions. Be honest and thorough in your responses to ensure accurate evaluation.
5. If required, provide details about any medical tests or exams you have undergone recently, such as blood tests or medical screenings.
6. If applicable, attach any supporting documents requested, such as medical records or doctor's statements.
7. Review the completed form to ensure all the necessary information has been provided. Double-check for accuracy and legibility.
8. Sign and date the form, confirming that all the information provided is true and accurate to the best of your knowledge.
9. Submit the form to the designated recipient, following any additional instructions provided.

Who needs evidence of insurability form:

1. Individuals applying for new life insurance policies may be required to provide evidence of insurability.
2. Employees enrolling in employer-sponsored insurance plans that offer options for additional coverage or higher benefit amounts may need to fill out this form.
3. Individuals seeking to increase their existing insurance coverage may be asked to provide evidence of insurability to assess their eligibility for the desired changes.

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What is evidence of insurability form?

The evidence of insurability form is a document that provides information on an individual's health and medical history.

Who is required to file evidence of insurability form?

Employees who are enrolling in a new insurance plan or increasing their coverage amount may be required to file an evidence of insurability form.

How to fill out evidence of insurability form?

The form can usually be filled out online or on paper, and requires personal information such as medical history, current health status, and contact details.

What is the purpose of evidence of insurability form?

The purpose of the form is to assess the risk of insuring an individual based on their health status, and to determine if they are eligible for coverage.

What information must be reported on evidence of insurability form?

Information such as medical history, current health status, contact details, and sometimes family medical history may be required on the evidence of insurability form.