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Instructions: Type or print using ball point pen. Complete both FRSL87580393 and FR85940598.ResetGROUP LIFE CONVERSION APPLICATION FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY This form is to be
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How to fill out group life conversion application

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How to fill out group life conversion application

01
Obtain the group life conversion application form from your employer or insurance provider.
02
Fill in your personal information, including your name, address, and contact details.
03
Provide your group policy number and details of the coverage you wish to convert.
04
Indicate whether you want to convert to an individual policy or adjust your coverage.
05
Include any required health information or medical history, if requested.
06
Review the application for accuracy and completeness.
07
Sign and date the application form.
08
Submit the completed application to your insurance provider within the required timeframe.

Who needs group life conversion application?

01
Individuals whose group life insurance coverage is expiring or being terminated.
02
Employees who are leaving their job and wish to maintain life insurance coverage.
03
Dependents of insured employees who need to convert their coverage.
04
People who want to adjust their existing life insurance benefits provided by employer-sponsored plans.
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A group life conversion application is a form that allows individuals covered under a group life insurance policy to convert their coverage to an individual life insurance policy after leaving the group plan.
Individuals who are losing their coverage under a group life insurance policy, such as employees who leave their job or dependents losing coverage due to specific circumstances, are required to file a group life conversion application.
To fill out the group life conversion application, individuals should provide personal information, details about the group policy, and select the type of coverage they wish to convert to, while ensuring all information is accurate and complete.
The purpose of the group life conversion application is to allow individuals to maintain life insurance coverage even after they have lost their group insurance through employment or other means.
The information that must be reported includes the individual's name, contact information, the group policy number, the amount of coverage being converted, and any other pertinent details required by the insurance company.
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