Get International Insurance Form

This guide provides clear and detailed instructions on how to fill out the International Insurance Form online. It aims to assist users in successfully completing their requests for insurance waiver while ensuring compliance with UM insurance requirements.

Follow the steps to complete the form accurately and efficiently.

1. Click ‘Get Form’ button to obtain the form and open it in the editing interface.
2. Enter your last name in the designated field to identify your request.
3. Fill in your first name alongside your last name for proper identification.
4. Indicate the name of your insurance company in the corresponding field.
5. Provide your UM I.D. number, ensuring that this information is current and accurate.
6. Input your policy number in the appropriate space, or specify the waiver end date if applicable.
7. State your waiver start date to indicate the beginning of coverage.
8. If your insurance is provided by a sponsor, check the box and input the name of the sponsor. If provided by a family member, check the respective box and provide their name and relationship.
9. If applicable, add the UM I.D. of the family member who is an employee.
10. Sign and date the form to validate your request.
11. Prepare to attach required documents, including proof of insurance and insurance plan booklet in English.
12. Submit the completed form and documents either in person at the International Center Insurance Office or by scanning and emailing to ihi@umich.edu.
13. After submission, await an email notification to your UM email regarding the status of your request.

Complete your International Insurance Form online today to ensure timely processing of your insurance waiver request.