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TheLincolnNationalLifeInsuranceCompany
GroupInsuranceServiceOffice
P.O. Box2616,Omaha,NE68114
Phone:8004232765Fax:8775736177
Email:lfgenrollments@LFG.com
EVIDENCEOFINSURABILITYINFORMATION
InstructionsforEmployeeApplicant(Pleasecompletetherequiredsectionsasnotedbelow.)
1.
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How to fill out evidence of insurability form
How to fill out evidence of insurability form
01
Obtain the evidence of insurability form from your insurance provider.
02
Fill out all required personal information such as name, address, date of birth, etc.
03
Provide details about your medical history, including past illnesses, surgeries, and medications.
04
Answer any questions about your lifestyle habits such as smoking or drinking.
05
Make sure to sign and date the form before submitting it back to the insurance provider.
Who needs evidence of insurability form?
01
Individuals applying for life insurance or disability insurance may need to fill out an evidence of insurability form.
02
Employers may require employees to fill out this form when enrolling in certain insurance benefits.
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What is evidence of insurability form?
Evidence of Insurability form is a document that provides information about the individual's health condition and other related factors to determine if they are eligible for insurance coverage.
Who is required to file evidence of insurability form?
Employees who are enrolling in a new insurance plan or applying for a higher coverage amount may be required to file evidence of insurability form.
How to fill out evidence of insurability form?
The form typically requires detailed information about the individual's medical history, lifestyle habits, and sometimes may require a medical examination by a healthcare provider.
What is the purpose of evidence of insurability form?
The purpose of evidence of insurability form is to assess the individual's health condition and other risk factors to determine their eligibility for insurance coverage and to calculate the insurance premium.
What information must be reported on evidence of insurability form?
Information such as medical history, family medical history, current medications, lifestyle habits, and sometimes results of a medical examination must be reported on the evidence of insurability form.
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