OTHER INSURANCE QUESTIONNAIRE 2026

1. Click ‘Get Form’ to open the OTHER INSURANCE QUESTIONNAIRE in the editor.
2. Begin by entering the NAME OF CLAIMANT at the top of the form. Ensure accuracy as this is crucial for processing your claim.
3. Indicate if the claimant is an INTERNATIONAL STUDENT or an EMANCIPATED STUDENT by checking the appropriate boxes.
4. Fill in details about the insured, including their NAME and POLICY NUMBER. If applicable, answer questions regarding parental status and responsibilities.
5. Complete employment information for both parents, including EMPLOYER NAME and ADDRESS. Be sure to check if they are employed, self-employed, or receiving public assistance.
6. Provide details about any group medical insurance coverage through employment, including type of plan and insurance company information.
7. Finally, review all entries for accuracy before signing. Ensure that both parent/guardian signatures are included if applicable.

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