Visitor Health Insurance, Pre-existing condition coverage, AIG

India Network Health Plan Forms - Please use these forms to fax or mail. Our Fax Number is: 407-479-3289.

Mailing Address: PO Box 22, Windermere, FL 34786

1. Membership form InfMem.pdf InfMem.doc

2. Insurance Enrollment Form InsForm.pdf InsForm.doc

3. Insurance Renewal Form RenewalForm.pdf RenewalForm.doc

Instructions: Print the forms and mail completed forms to
India Network Services, PO Box 22, Windermere, FL 34786 along with checks for correct amount of premium and membership fee ($10), payable to 'India Network Services'. or fax completed forms to 407-479-3289 or 1-800-837-6384.

4. Cancellation Form (Only if cancellation occurs before start date of coverage).

5. Claim Form (in pdf format) - Insured must complete the first page of claim form (according to policy number) and file with AIG Claims Office either directly or along with provider office. Also, get a notarized affidavit duly signed by visitor to authorize US person to discuss claim status/questions with AIG.