Claim Information
An Accident has occurred which resulted in an Injury and
unexpected medical bills. How do you go about filing a claim?
Helpful Hints for Filing a Claim
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Print out the correct claim form - Sentry Claim Form for
Student Accident and Mutual of Omaha for Catastrophic Accident Medical.
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Print or type clearly on the claim form and try to refrain
from using abbreviations for your city or county. Be specific in your
description of what happened.
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Attach all itemized bills and any Explanation of Benefits from other
insurance sources.
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Make copies of everything that you send in to the claims
processor.
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Mail to the address in the upper left-hand corner of the
claim form.
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Give the claims office 15 business days before calling to check the
status of your claim.
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Any additional bills and Explanation of Benefits received
after filing your original claim, should be sent in along with a copy of the
claim form to the address in upper left-hand corner of the claim form within
90 days of the date of service.
Please note that bills must be sent within 90 days of the
date of service, to the company identified with the claimants name, school
district (if applicable) and date of Accident. If you have other insurance, file
simultaneous claims with your other insurance carrier to avoid delays in
benefits payments.
Completion of a claim form does not guarantee benefit
payment. Each claim is reviewed according to policy provisions.
Click on the link below to printout the claim form needed.
Student
Accident Claim Form
Catastrophic Accident
Medical Claim Form
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