Get 10344.indd Bcbsm Subrogation Unit Questionnaire - Bcbsm.com

Completing the 10344.indd BCBSM Subrogation Unit Questionnaire is an essential step in addressing your subrogation case. This guide provides clear, step-by-step instructions to help you navigate the form effectively and submit it online.

Follow the steps to complete the questionnaire successfully.

1. Press the 'Get Form' button to begin your process of obtaining the questionnaire and access it easily in the editor.
2. Enter the date at the top of the form to establish the timeline for your submission. This is crucial for record-keeping.
3. Fill in the client’s name as it appears on the insurance policy. Next, input the client’s date of birth to confirm identity.
4. Locate and provide the contract number, which is the 9-digit number found on the BCBSM card, ensuring accuracy for proper processing.
5. If applicable, include the spouse's name if they are covered under the same BCBSM policy. Write the spouse’s date of birth as well.
6. Provide the name of the BCBSM policy holder if it differs from the client, alongside their date of birth.
7. Input the client’s phone number for follow-up purposes. Ensure the number is current and correct.
8. Choose the type of case by selecting one from the options provided, such as personal injury, product liability, or motor vehicle accident.
9. Specify the state where the incident took place for jurisdictional clarity.
10. Indicate whether a vehicle was involved in the case by selecting 'Yes' or 'No.'
11. If applicable, provide the details about the jurisdiction and date of injury. This helps to establish the legal context of the case.
12. Describe the type of injury and the affected area of the body to give a complete overview of the case.
13. Fill in the attorney’s details, including their name, law firm, address, and contact information, which is vital for legal communication.
14. Complete the insurance company information and adjuster’s contact details, as this will need to be referenced throughout the claims process.
15. Finally, review all entered information for accuracy and completeness. After this, you can save changes, download the form, print it, or share it as necessary.

Complete your 10344.indd BCBSM Subrogation Unit Questionnaire online today.