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Claim Forms

   Type of Claim Form(s) Required
1 Medical – Illness CSA
Student/Scholar Verification (if applicable)
2 Medical-Accident CSA
Accident Questionnaire
Student/Scholar Verification (if applicable)
Student/Scholar Sports Accident Questionnaire (if   applicable)
Adventure Sports Accident Questionnaire (if applicable)
3 Emergency Medical Evacuation #1. and/or #2. above
Emergency Medical Evacuation Reunion Bedside Visit
4 Reunion #1.  and/or #2. above
Emergency Medical Evacuation Reunion Bedside Visit
5 Bedside Visit #1.  and/or #2. above
Emergency Medical Evacuation Reunion Bedside Visit
6 Repatriation of Mortal Remains #1. and/or #2. above
Accidental Death/Repatriation of Remains Questionnaire
7 Local Burial or Cremation #1. . and/or #2. above
Accidental Death/Repatriation of Remains Questionnaire
8 Return of Minor Child(ren) Return Minor Child Questionnaire
9 Trip Interruption Trip Interruption Claim
10 Natural Disaster Replacement
Accommodations
Natural Disaster Daily Replacement Accommodation/ Natural Disaster Evacuation and Repatriation
11 Natural Disaster Evacuation
and Repatriation
Natural Disaster Daily Replacement Accommodation/ Natural Disaster Evacuation and Repatriation
12 Political Evacuation and Repatriation Political Evacuation and Repatriation Claim
13 Accidental Death #2 above
Accidental Death/Repatriation of Remains Questionnaire
14 Lost Checked Luggage Lost Checked Items
15 Personal Liability Personal Liability Claim
Student/Scholar Verification (if applicable)
16 Lost Checked Personal Equipment Lost Checked Items