APPLICATION FOR INSURANCE - GOLDEN RULE INSURANCE COMPANY 2025

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  1. Click ‘Get Form’ to open the APPLICATION FOR INSURANCE in the editor.
  2. Begin by filling out the Applicant’s Data section. Enter your full name, marital status, Social Security number, and driver’s license number. Ensure you print in black ink for clarity.
  3. Provide your home address and contact information. Include your employer's name and occupation details, along with prior employment if applicable.
  4. In the POLICY INFORMATION section, select your desired plan type and enter the requested effective date. Specify any optional benefits you wish to include.
  5. Complete the Applicant’s History section by answering all questions regarding current insurance coverage and medical history accurately.
  6. Review all entered information for accuracy before signing at the end of the application. Use our platform's features to easily navigate back if corrections are needed.

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Round-the-Clock Service for Your Convenience. For claims, accidents, billing information, and more, you can contact an Allied representative 24 hours a day, seven days a week at 800-282-1446.
Golden Rule is a provider of Medicare Supplement Insurance plans, Vision, Dental, and Life plans. To find out more information about Golden Rule Medigap plans, contact a Golden Rule Medicare Supplement representative today or use our quote form below.
The Golden Rule In Insurance If Its Not in Writing, It Didnt Happen. With contracts and agreements, having everything in writing is usually the best policy. In the world of insurance, this suggestion is considered The Golden Rule.
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