Form preview

Get the free Statement of Insurability

Get Form
This document is used to provide detailed personal, employment, income, and medical information for individuals applying for life insurance coverage through Unimerica Life Insurance Company. It includes
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign statement of insurability

Edit
Edit your statement of insurability form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your statement of insurability form via URL. You can also download, print, or export forms to your preferred cloud storage service.

How to edit statement of insurability online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
To use our professional PDF editor, follow these steps:
1
Create an account. Begin by choosing Start Free Trial and, if you are a new user, establish a profile.
2
Prepare a file. Use the Add New button. Then upload your file to the system from your device, importing it from internal mail, the cloud, or by adding its URL.
3
Edit statement of insurability. Replace text, adding objects, rearranging pages, and more. Then select the Documents tab to combine, divide, lock or unlock the file.
4
Save your file. Choose it from the list of records. Then, shift the pointer to the right toolbar and select one of the several exporting methods: save it in multiple formats, download it as a PDF, email it, or save it to the cloud.
With pdfFiller, it's always easy to work with documents.

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out statement of insurability

Illustration

How to fill out Statement of Insurability

01
Read the instructions carefully.
02
Gather necessary personal information, such as your name, address, and Social Security number.
03
Provide details about your health history, including any pre-existing conditions.
04
Disclose any medications you are currently taking.
05
Answer questions regarding your lifestyle habits, such as smoking or drinking alcohol.
06
Review your answers for accuracy and completeness.
07
Sign and date the form before submission.

Who needs Statement of Insurability?

01
Individuals applying for life insurance or health insurance.
02
Employees enrolling in employer-sponsored insurance programs.
03
Anyone who has had a change in health status since the last application.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.5
Satisfied
61 Votes

People Also Ask about

Evidence of Insurability (EOI) is a record of a person's past and current health events. It's used by insurance companies to verify whether a person meets the definition of good health.
Evidence of insurability (EOI) is the healthcare information that is collected to determine the insurance company's level of risk associated with extending health or life insurance to someone.
An individual with very low insurability may be said to be uninsurable, and an insurance company will refuse to issue a policy to such an applicant. For example, an individual with a terminal illness and a life expectancy of 6 months would be uninsurable for term life insurance.
Definitions of insurability. noun. the quality of being insurable; the conditions under which an insurance company will issue insurance to an applicant (based on standards set by the insurance company) antonyms: uninsurability.
Evidence of Insurability (EOI) is a record of a person's past and current health events. It's used by insurance companies to verify whether a person meets the definition of good health.
Securing evidence of insurability for life insurance typically involves submitting comprehensive details about one's health, medical history statement, and lifestyle choices to the prospective insurer. This process, known as insurance underwriting, is crucial in determining the premium the insurance company charges.

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

A Statement of Insurability is a document that individuals complete to provide information about their health and medical history when applying for life or health insurance coverage.
Typically, individuals applying for life insurance, long-term disability insurance, or certain health insurance policies are required to file a Statement of Insurability.
To fill out a Statement of Insurability, applicants should provide personal information, detail their medical history, and answer any questions regarding previous illnesses, treatments, or medications honestly and thoroughly.
The purpose of the Statement of Insurability is to assess the risk associated with insuring the applicant by gathering necessary health information to determine eligibility and premium rates.
Information that must be reported typically includes personal details, medical history, current health status, medications taken, and any past treatments or surgeries related to health.
Fill out your statement of insurability online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.