Get Mediation Form.doc

Filling out the Mediation Form.doc online is a straightforward process designed to help insurance companies engage in the Kansas Alternative Mediation Program. This guide will walk you through each section of the form, ensuring that you provide the necessary information effectively and efficiently.

Follow the steps to complete the Mediation Form.doc online.

1. Press the ‘Get Form’ button to access the Mediation Form.doc and open it in your editor.
2. Enter the name of the insurance company in the designated field labeled 'Insurance Company Name.' This should be the official name of the company entering the mediation.
3. Input the NAIC number in the 'NAIC #' field. This number identifies the insurance company and can typically be found on company correspondence or their website.
4. Provide a contact person for the insurance company in the 'Insurance Company Contact Person' section. Ensure this person is knowledgeable about the mediation process.
5. Fill in the contact person's direct e-mail address in the corresponding field labeled 'Insurance Company Contact Person’s Direct E-Mail.' This should be an active email that can receive important communication.
6. Enter the direct phone number of the contact person in the 'Insurance Company Contact Person’s Direct Phone No.' field. This phone number is essential for quick communication during the mediation.
7. Fill out the fax number for the contact person in the 'Insurance Company Contact Person’s Fax No.' section, if applicable.
8. Ensure the authorized signer’s name is written clearly in the 'Authorized Signer for the Insurance Company' line. This person is responsible for representing the company in the mediation.
9. Review all entries carefully to ensure accuracy and completeness before finalizing your submission.
10. After completing the form, you can save your changes, download the document, print it for your records, or share it as needed.

Complete your mediation documentation online today for a smoother resolution process.