2006-2007
Student Accident & Sickness Plan

• 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.
• Claim forms are available from your college's Student Services office.  Or here.
• 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.
• 2006 - 2007 Student Accident Insurance plan brochure.
  

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