Active membership | American Academy of Insurance Medicine

Active membership shall consist of physicians (MD or DO) who are medical directors, associate medical directors, assistant medical directors, or medical consultants for insurance companies. Active members shall be entitled to hold office, vote, serve on committees, make nominations and generally exercise the rights of full membership.

Name:*

First Name Required Last Name Required

Address Line 1:* Address Line 1 is Required

Address Line 2: Address Line 2 is not valid

City:* City is Required

Country:* Country is Required

State/Province:* State/Province is Required

Zip/Postal Code:* Zip/Postal Code is Required

Middle Name: Middle Name is not valid

Title:* Title is Required

Credentials:* Credentials is Required

Professional Position / Title:* Professional Position / Title is Required

Company Name:* Company Name is Required

Company Country:* Company Country is Required

Company State:* Company State is Required

Company City:* Company City is Required

Company Address:* Company Address is Required

Company ZIP Code:* Company ZIP Code is Required

Company Office Phone:* Company Office Phone is Required

Home Address:* Home Address is Required

Home City:* Home City is Required

Home State:* Home State is Required

Home ZIP Code/Postal Code:* Home ZIP Code/Postal Code is Required

Home Country:* Home Country is Required

Preferred Phone: Preferred Phone is not valid

Preferred Mailings:* Preferred Mailings is Required

Office Home

Medical School:* Medical School is Required

Year of Graduation:* Year of Graduation is Required

What is your field of specialization?:* What is your field of specialization? is Required

If you have a sub-specialization please select from the list below:* If you have a sub-specialization please select from the list below is Required

State/Prov Medical License Issued:* State/Prov Medical License Issued is Required

Member of AMA::* Member of AMA: is Required

Yes No

BIM Certified:: BIM Certified: is not valid

Yes No

Profile Image: Profile Image is not valid

Username:* Invalid Username

Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

Secure Payment

No val Please fix the errors above

Pay American Academy of Insurance Medicine

$612 for access until 31 December 2025

	Active membership – Payment $612 for access until 31 December 2025	$612.00
	Total	$612.00

Active membership – Payment

$612 for access until 31 December 2025

$612.00

Total

$612.00