Get Ks Lewermark Student Insurance Claims Questionnaire 2020-2025

Completing the KS LewerMark Student Insurance Claims Questionnaire is a vital step in ensuring that your insurance claim is processed efficiently. This guide provides a clear and comprehensive overview of each section of the form to help you fill it out correctly.

Follow the steps to successfully complete your insurance claims questionnaire.

1. Click ‘Get Form’ button to obtain the form and open it.
2. Enter your date of birth in the format mm/dd/yyyy to confirm your identity.
3. Include your insurance I.D. number, which is critical for processing your claim.
4. Provide your full name as it appears on your insurance policy.
5. Indicate the name of your school to link your claim to the correct institution.
6. Fill in your e-mail address to ensure you can be contacted regarding your claim.
7. Choose the appropriate section based on your claim's nature—injury or sickness—and answer the related questions thoroughly.
8. If your claim is for an injury, explain how the injury occurred, answer yes or no to questioning about sports participation, and provide details about any car accidents related to the injury.
9. If your claim is for sickness, disclose any previous treatments for the condition and list all medications you are currently taking.
10. If you have other insurance, provide details about all policies and previous claims filed.
11. If completing the form on behalf of a student, fill out the additional information, including your relationship to the student.
12. Read the authorization statement carefully and insert your signature by typing your name and insurance ID number in the designated space, certifying that you are the insured student.
13. Review all provided information for accuracy, then submit the completed form either electronically or by mailing it to the address listed.

Complete your KS LewerMark Student Insurance Claims Questionnaire online today!