Privacy Request Form

In some jurisdictions, applicable law may entitle you to make certain requests in connect with your personal information. Before Student Insurance, LLC (“Student Insurance”) can honor your request, we are required by law to verify your identity. Please complete this form to begin the verification process.

For more information on how Student Insurance handles personal information and how our verification process works, please review our Privacy Policy on our website at www.studentinsuranceusa.com.

"*" indicates required fields

This field is for validation purposes and should be left unchanged.