Claims

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

1. Print out the correct claim form - click on the state appropriate form for the claim form for the enrolled coverage.

2. 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.

3. Attach all itemized bills and any Explanation of Benefits from other insurance sources.

4. Make copies of everything that you send in to the claims processor.

5. Mail to the address in the upper left-hand corner of the claim form.

6. Give the claims office 15 business days before calling to check the status of your claim. To contact Sentry, call toll free (800) 426-7234.  To contact Administrative Concepts, Inc., call toll free (888) 293-9229 or visit their secure website, www.visit-aci.com, to instantly access claims status.  To contact Mutual of Omaha, call toll free (800) 524-2324.

7. 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 based on your state.