Standard Insurance Company Medical Questionnaire
It is within your rights to decline to give authorisation for information to be passed to the company.
Standard insurance company medical questionnaire. The standard is a marketing name for standard insurance company portland oregon licensed in all states except new york and the standard life insurance company of new york white plains new york licensed only in new york. The company s underwriters will then assess whether the information you give is relevant. Buy your insurance quotation here car insurance travel insurance property insurance cellphone insurance retrieve your saved insurance quote. This medical questionnaire is aimed towards people trying to get an insurance rather than being enrolled in a medical institution.
This questionnaire is designed to help the company meet its legal health and safety duties. I hereby consent to hdfc standard life insurance company ltd. Medical examinations are normally carried out by an independent examiner. Information about the standard health questionnaire submitting your questionnaire if you are applying for family coverage a separate questionnaire must be completed for each family member.
The document is free to download. Medical questionnaire section 1 personal details of scheme member. Shall be deemed to be incorporated in this application. The questionnaire here is incredibly detailed making sure that the potential customer is completely transparent with the insurance company.
Ca si 9354 101770 1 of 3 5 17 standard insurance company medical history statement 900 sw fifth avenue portland or 97204 for residents of california check yes or no for each of these questions and give details for any yes answers. Health questionnaire for use with any standard life pension or pension contribution insurance contract. Washington state health insurance pool 10 01 09 page 2 3 revised 032312 part 1. Company medical advisor who will treat the information in the strictest confidence.
Do not send medical records with this questionnaire. Products and availability vary by state and are solely the responsibility of the applicable insurance company.
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