Filing an Accident Medical Claim with the Supplemental Athletic Insurance
1. Print out the claim form (click on link at the bottom of the page).
2. An official with FCHAA should complete part “A” on the form.
3. The injured person (or parent/guardian) should complete part “B” on the form.
4. Print or type clearly on the claim form and try to refrain from using abbreviations for your city or county.
5. Be specific in your description of what happened.
6. Attach all bills and any Explanation of Benefits from other insurance sources.
7. Make copies of everything that you send in to the claims processor.
8. Mail to the address indicated on the claim form.
9. Give the claims office 2 weeks before calling to check the status of your claim.
10. 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 indicated on 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. 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.