Ameritas Life Insurance and the 3963 Form: What You Need to Know

What Is the 3963 Form?

The 3963 form, also known as the "Form 3963 – Request for Information" or "Request for Information for the Applicant," is a standardized document used by many life insurance carriers, including Ameritas, to collect additional details from applicants. It is typically required when the initial application does not contain all the data needed for underwriting, such as medical history, employment details, or financial information.

Why Ameritas Uses the 3963 Form

Ameritas employs the 3963 form to streamline the underwriting process and ensure that all necessary data is captured in a consistent format. By requesting the same information from every applicant, Ameritas can compare policies more efficiently, reduce errors, and maintain compliance with regulatory standards. The form is also useful for gathering updates if an applicant's circumstances change after the initial application.

Key Sections of the 3963 Form for Ameritas Applicants

• Personal Identification: Name, address, Social Security Number, and contact details.
• Medical History: Current health conditions, past surgeries, medications, and family medical history.
• Employment and Income: Current employer, position, annual income, and employment duration.
• Financial Information: Assets, liabilities, and any existing life insurance coverage.
• Additional Disclosures: Lifestyle factors such as smoking, alcohol use, and recreational activities.

Submitting the 3963 Form to Ameritas

Ameritas allows applicants to submit the 3963 form through several convenient methods:

• Online Portal: Log in to the Ameritas member portal, navigate to the "Documents" section, and upload a scanned copy of the completed form.
• Mail: Send a signed, completed form to the address listed on the application package or the customer service office.
• Email: Attach a PDF of the form and send it to the designated underwriting email address.

When submitting electronically, ensure the file is clear and all fields are legible to avoid delays.

Common Questions About the 3963 Form

Do I need to fill out the 3963 form if I've already submitted a medical exam?

Yes. The medical exam provides specific test results, whereas the 3963 form asks for broader health and lifestyle information. Both pieces are required for a complete underwriting file.

How long does it take for Ameritas to process the 3963 form?

Processing times vary, but Ameritas typically reviews the form within 5–7 business days. If additional information is needed, the underwriting team will contact the applicant directly.

Can I request a waiver for the 3963 form?

Ameritas generally requires the form for all standard policies. However, if you have a unique situation, contact the underwriting department to discuss alternatives.

What happens if I submit incomplete information?

Incomplete submissions can delay the underwriting process or result in a denial. Always double‑check that every section is fully answered before sending.

Tips for Completing the 3963 Form Accurately

• Read each question carefully and provide honest, detailed answers.
• Keep a copy of the completed form for your records.
• If you're unsure about any medical terminology, ask your healthcare provider for clarification.
• Use a pen or digital signature that is clear and legible.

How the 3963 Form Influences Your Policy Outcome

Ameritas uses the data from the 3963 form to assess risk, determine appropriate coverage levels, and set premiums. Accurate information helps ensure that you receive a fair quote and avoid surprises later, such as premium increases or coverage exclusions.

Next Steps After Submitting the 3963 Form

Once Ameritas receives and reviews the 3963 form, the underwriting team will either approve the policy, request additional information, or, in rare cases, deny coverage. If approved, you will receive the final policy documents and a summary of your coverage.

Resources for Further Assistance

For additional guidance on completing the 3963 form, visit Ameritas's official website or call their customer support line. They can provide templates, answer specific questions, and ensure your submission meets all requirements.