How do I file a claim?
1. Notify the school and obtain a form immediately. They will fill out Part A if it is a school injury. You also may download a printable form here.
2. Parents complete Part B. Answer all questions.
3. Submit copies of your itemized bills to your own family insurance first, even if you have a large deductible. You will be sent a report called an Explanation of Benefits (EOB). This Plan is supplemental to all other valid coverage. You must file a claim with your other coverage first! This Plan DOES NOT cover penalties imposed for failure to use providers preferred or designated by your primary coverage.
4. Send our claim form, copies of itemized bills and the EOB to:
STUDENT ASSURANCE SERVICES, INC.
P.O. BOX 196
STILLWATER, MN 550825. No claim can be completed until all of the above documents have been provided.
NOTE: Student must have been treated by a licensed physician within 60 days of the date of injury. Proof of claim should be submitted within 90 days from the date of accident, or a reasonable time thereafter not to exceed one year. Itemized bills should be submitted within 90 days from the date of treatment or reasonable time thereafter not to exceed one year. We are responsible only for expenses incurred within one year.
Administered by
STUDENT ASSURANCE SERVICES, INC.
P.O. BOX 196
STILLWATER, MN 55082
(800) 328-2739
(651) 439-7098
Underwritten by
Security Life
Minnetonka, Minnesota
NOTICE: THE POLICY CONTAINS A PROVISION LIMITING COVERAGE TO USUAL AND CUSTOMARY CHARGES. THIS LIMINTATIO MAY RESULT IN ADDITIONAL OUT-OF-POCKET EXPENSES FOR THE INSURED.
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