Claims Administrator
for Student Insurance Policies

2008-2009
Student Accident & Sickness Plan

1. A claim for medical services must be completed and returned to the insurance company within 120 days of the injury or first date of sickness.
2. Claim forms are available from your college's Student Services office.
3. Complete the Claimant's portion of the form, present it to the doctor or hospital rendering the service for diagnosis and itemized statement, and attach all itemized doctor and hospital bills.
4. Forward all completed claim forms to:

   Personal Insurance Administrators Inc.
   P.O. Box 6040
   Agoura Hills, CA 91376-6040

   Toll Free: 1-800-468-4343
   www.piaclaims.com