Please note that bills must be sent to the company identified within 90 days of the date of service, with the claimants name, policy number, school district (if applicable) and date of Accident. Please follow the instructions below to file a claim.
Completion of a claim form does not guarantee benefit payment. Each claim is reviewed according to policy provisions.
Your student has been injured and you need to file a claim. Simply select your State and click on Lookup. Select your school or district from the listings shown on the right. The click on the claim form link and print the form.
ALL INFORMATION MUST BE PROVIDED IN ORDER FOR CLAIM TO BE PROCESSED
KEEP COPIES OF ALL CLAIM FORMS, BILLS, AND CORRESPONDENCE FOR YOUR OWN RECORDS UNTIL YOUR CLAIM HAS BEEN PROCESSED.