Allianz Life Insurance Company of North America The underwriting process What to expect when applying for life insurance M3734 Product and feature availability may vary by state. Page 1 of 6
How to help ensure the underwriting of your life insurance policy goes smoothly In order to speed up our underwriting process, we will need some additional information. Allianz Life Insurance Company of North America (Allianz) places the highest priority on your privacy. Any information we collect will be held in strictest confidence. You can expect to be personally contacted for the following reasons: 1. A personal information interview In the coming week, a representative from Allianz will contact you to obtain information. Depending on your answers, the average length of the interview can take 30-40 minutes. Please make sure you have enough time to complete the interview. We also recommend filling out the included worksheet to help you prepare for the interview. After we contact you, please return our call as soon as possible at 800.729.9566. Our hours of operation are: Monday and Tuesday 8:00 a.m. to 8:00 p.m. Central time Wednesday and Thursday 8:00 a.m. to 6:00 p.m. Central time Friday 8:00 a.m. to 4:30 p.m. Central time Although we will do our best to contact you at your requested time, please keep in mind that this is not a preset appointment and you may be contacted at a different time. 2. A medical exam To fairly assess your eligibility for life insurance, you may need to take some medical tests such as: Blood pressure and pulse readings Height and weight measurements Blood test and urinalysis A resting or exercise electrocardiogram An examiner will call you to schedule these tests. We rely on your help to complete this step efficiently and to ensure you receive your policy quickly. Make sure you schedule your appointment for the exam as soon as possible. Page 2 of 6
3. A current financial statement or other financial documents You may need to fill out a personal or business financial statement. This gives us a current snapshot of your finances. Your insurance agent will let you know if one needs to be completed. Additional commonly requested documents Along with the previous list, we may require other information. Depending on the type and amount of coverage you are requesting, we may need: 1. An Attending Physician s Statement We may contact your physician or clinic to obtain your medical records. It is extremely important that we have your doctor s correct name and address. Be sure to let us know if you have recently visited your doctor under your maiden name, for example, or a patient number (like those assigned by a Kaiser Medical Facility). 2. Your motor vehicle record 3. A prescription database check 4. A background check Allianz will review the information we receive from your telephone interview and the other sources listed above. Based on this information, we will either: approve your application and issue your life insurance policy, approve it with exclusions or other changes, or decline your application. If your request for coverage is approved, we will prepare your life insurance policy along with a final application for your signature. These will be mailed to your licensed insurance agent who will present them to you for your approval. You ll need to sign both copies of the final application to confirm you understand and agree with its terms. Your insurance agent will give you a copy of your signed application along with your life insurance policy and will forward the other signed copy to the home office for our records. If you have any questions or need more information, please contact your licensed Allianz insurance agent. Page 3 of 6 2
The Personal Information Interview worksheet To help keep this call as brief as possible, please gather the following information before the interview. You may want to fill out the sections below to assist you in completing the phone call. You ll be asked questions regarding: 1. Your understanding of the sale including if it meets your overall financial objectives, if is it affordable, etc.? 2. If you have other insurance in force or applied for Name of company Face/benefit amount Date issued or applied for Current status In force Applied for In force Applied for In force Applied for 3. Financial information Annual income: $ Sources of income: Net worth: $ Sources of premium: 4. Personal physician Date last seen Reason seen Doctor s name Address Phone Page 4 of 6 3
5. What other doctors have you seen in the past five years, including any hospitalizations, surgeries, or medical tests? Date last seen Reason seen Doctor s name Address Phone 6. Current medications (You may want to gather your prescription bottle(s) for this information) Medication Dosage Frequency Reason prescribed 7. You ll be asked for your family history, including if any family member (mother, father, or siblings) has been diagnosed with and/or treated for cancer, stroke or aneurysm, heart disease, heart surgery including coronary bypass or heart failure, or any neurodegenerative disorder. Is your mother living? YES NO If no, what was her age at death? Is your father living? YES NO If no, what was his age at death? Relationship to you Age at diagnosis Type of condition diagnosed Age at death if applicable 8. Your driver s license number: State of issue Please be prepared to comment on any moving violations or accidents in the past five years. Thank you for applying for Allianz life insurance. We look forward to making your underwriting experience as simple and efficient as possible. 4 Page 5 of 6
True to our promises so you can be true to yours. A leading provider of annuities and life insurance, Allianz Life Insurance Company of North America (Allianz) bases each decision on a philosophy of being true: True to our strength as an important part of a leading global financial organization. True to our passion for making wise investment decisions. And true to the people we serve, each and every day. Through a line of innovative products and a network of trusted financial professionals, and with over 2.2 million contracts issued, Allianz helps millions of people as they seek to achieve their financial and retirement goals. Founded in 1896, Allianz is proud to play a vital role in the success of our global parent, Allianz SE, one of the world s largest financial services companies. While we pride ourselves on our financial strength, we re made of much more than our balance sheet. We believe in making a difference with our clients by being true to our commitments and keeping our promises. People rely on Allianz today and count on us for tomorrow when they need us most. Guarantees are backed solely by the financial strength and claims-paying ability of Allianz Life Insurance Company of North America. www.allianzlife.com Products are issued by: Allianz Life Insurance Company of North America 5701 Golden Hills Drive Minneapolis, MN 55416-1297 800.950.1962 Page 6 of 6 (R-5/2012)