Note: Insurance company makes decision on claims. Download appropriate policy claim form.
Tokio Marine HCC - Medical Insurance Services Group | Download Claim Forms | Fax | Insurance Company Phone | ||
---|---|---|---|---|---|
Atlas America | Must submit proof of claim with in 60 days from date of service Must submit Appeal to | 317-262-2140 | Tokio Marine HCC - Medical Insurance Attention: Claims Department P.O Box 2005 Farmington Hills, MI 48333-2005 | 800-605-2282 Or 317-262-2132 | |
Atlas International | |||||
Atlas Essential | |||||
Atlas Essential International | |||||
Atlas Premium | |||||
Atlas Premium International | |||||
VisitorSecure | |||||
StudentSecure Select - Including USA | |||||
StudentSecure Select - Excluding USA | |||||
StudentSecure Budget - Including USA | |||||
StudentSecure Budget - Excluding USA | |||||
StudentSecure Smart - Including USA | |||||
StudentSecure Smart - Excluding USA | |||||
Seven Corners | Download Claim Forms | Fax | Insurance Company Phone | ||
Inbound USA Basic | Must send claim form and payment receipts with in 90 days from date of service | 317-575-2256 | Seven Corners Attention: Claims Department 303 Congressional Boulevard Carmel, IN 46032 | 800-335-0611 Or 317-575-2656 | |
Inbound USA Choice | |||||
Inbound USA Elite | |||||
Liaison Travel Choice - Excluding USA | |||||
Liaison Travel Choice - Including USA | |||||
Liaison Travel Economy - Excluding USA | |||||
Liaison Travel Economy - Including USA | |||||
Liaison Travel Elite - Excluding USA | |||||
Liaison Travel Elite - Including USA | |||||
MCIS Flexible Travel Insurance - Including USA | |||||
MCIS Flexible Travel Insurance - Excluding USA | |||||
Liaison Student | Claim Form | ||||
International Medical Group (IMG) | Download Claim Forms | Fax | Insurance Company Phone | ||
Visitors Care | Must submit proof of loss | 317-655-4505 | International Medical Group Attention: Claims Department P.O Box 88500 Indianapolis, IN 46208-0500 | 800-628-4664 or 317-655-4500 | |
Patriot America | |||||
Patriot America Plus | |||||
Patriot Platinum America | |||||
Patriot GoTravel America | |||||
Patriot International | |||||
Patriot Platinum International | |||||
Patriot GoTravel International | |||||
Patriot Green America | |||||
Patriot Green International | |||||
Patriot Exchange Program | |||||
Student Health Advantage - Including USA | |||||
Student Health Advantage - Excluding USA | |||||
USI Affinity Travel Insurance Services | Download Claim Forms | Fax | Phone Company Phone | ||
Visit USA HealthCare - Budget | Must submit proof of claim with in 60 days from date of service | 317-262-2140 | HCC Medical Insurance Services, LLC Attention: Claims Department P.O Box 2005 Farminton Hills, MI 48333-2005 | 800-605-2282 Or 317-262-2132 | |
Visit USA HealthCare - Standard | |||||
Visit USA HealthCare - Superior | |||||
Inter Medical | |||||
WorldMed | |||||
Study USA Healthcare | |||||
Study USA Healthcare Preferred | |||||
Trawick International | Download Claim Forms | Fax | Insurance Company Phone | ||
Safe Travels for Visitors to the USA | Must submit proof of loss with in 90 days from date of service. GBGclaims@cbpinsure.com | NA | GBG Administrative Services Inc. Co-ordinated Benefit Plans, LLC on Behalf of Global Benefits Group, PO Box 2069 Fairhope AL 36533 | Toll-Free: 866-669-9004 | |
Safe Travels International | |||||
Safe Travels International Cost Saver | |||||
Safe Travels USA | |||||
Safe Travels USA Comprehensive | |||||
Safe Travels USA Cost Saver | |||||
Global Underwriters | Download Claim Forms | Fax | Insurance Company Phone | ||
Diplomat America | Must submit proof of loss with in 60 days from date of service | 513-533-9416 | Global Claims Administration 3195 Linwood Road, Suite 201 Cincinnati, OH 45208 | US & Canada 800-513-2981 Outside US & Canada 1-513-533-1330 | |
Diplomat Long Term | |||||
Diplomat International | |||||
Azimuth Risk Solutions | Download Claim Forms | Fax | Insurance Company Phone | ||
Beacon America | Must submit proof of loss | 317-423-9620 | Azimuth Risk Solutions Attention: Claims Department P.O Box 627 Indianapolis, IN 46206 | 888-201-8850 | |
Beacon International | |||||
INF Healthcare | Download Claim Forms | Fax | Insurance Company Phone | ||
INF Advantage | Axis Insurance Company Claim Form WEBTPA HIPPA Authorization Form | CHUBB Claim Form Administrative Concepts, Inc. (ACI) Axis Insurance Company Claim Form WebTPA Claims | CHUBB Claim Form 610-293-9299 Axis Insurance Company Claim Form 469-417-1989 | CHUBB Claim Form 994 Old Eagle School Rd., Suite 1005, Wayne, PA 19087-1706 Axis Insurance Company Claim Form PO Box 99906, Grapevine, TX 76099-9706 | CHUBB Claim Form 888-293-9229 Axis Insurance Company Claim Form 928-494-0112 |
INF Choice | |||||
INF Elite Network | |||||
INF Premier | |||||
INF Select Care | |||||
INF Short Term Elite | |||||
INF Short Term Premier | |||||
INF Standard | |||||
INF Traveler USA |