Insurance forms
Below are forms you may need:
Mac users: Please ensure to fill out the form using Adobe reader.
- Application for Insurance form (AMA disability, life, critical illness, professional overhead expense)
- Application for Accidental Death and Dismemberment Insurance form
- Beneficiary Designation forms:
- Life Insurance (AMA policy #4328)
- Accidental Death & Dismemberment (AMA policy # 50092201)
- Guaranteed Insurability Benefit (GIB) Rider forms (forms for physicians who have added the GIB rider):
- GIB application form (for full practicing physicians)
- GIB application form (for resident physicians)
- GIB application form (for professional overhead expense insurance)
- Future Insurability Option (for disability Insurance)
- 2021 GIB Commonly Asked Questions
- Disability Insurance Income Benefit Guide
- Disability Rate Sheet
- Professional Overhead Expense Rate Sheet
