If a claim form has not been received, please click below for a blank claim form.
Claim Form: Print and complete (PDF)
Claim Form: Fillable (PDF)
Get Adobe Reader

Claims — 2015-2016 and 2014-2015 Season


Complete Claims Management Professionals

Assistance — 24 hours a day, 7 days a week. You must call within 24 hours of any claim, emergency medical or dental treatment:
1-888-803-3324 or 954-308-3905 (collect)
Claims Department — 9am to 5pm ET Monday to Friday for general claim questions or questions regarding your existing claim:
1-866-772-5577 or 905-830-2919 (collect)