Health Special Risk Claim Forms

Student Health Insurance: For Academic Health Plans: please refer to your local University Web Site or the AHP web site.

• Wells Fargo Study Abroad Travel Assistance and Medical Emergency Claim Form
• Wells Fargo Study Abroad Trip Cancellation/Interruption and Baggage Loss Claim Form
• Trucking Claim Form  

• ABUA Disability Claim Form  

• AYSO Claim Form
• AYSO Spanish Claim Form  

• Boy Scouts of America Generic Claim Form
• Boy Scouts of America National Events Claim Form
• Boy Scouts of America International Claim Form
• BSA - Arrow Corp 5 - Bridger-Teton National Forest Claim Form
• BSA - Arrow Corp 5 - George Washington & Jefferson National Forest Claim Form
• BSA - Arrow Corp 5 - Manti - La Sol National Forest Claim Form
• BSA - Arrow Corp 5 - Mark Twain National Forest Claim Form
• BSA - Arrow Corp 5 - Shasta - Trinity National Forest Claim Form
• Learning for Life Claim Form  

• CYSA Claim Form  

• LCG Claim Form  

• Fraternity/Sorority - How to File a Claim Form
• Fraternity/Sorority - Claim Form
• Markel General Claim Form  

• HSR Accidental Death & Dismemberment (AD&D) Claim Form
• HSR Other Insurance Affidavit Form
• HSR Disability Claim Form
• HSR Accident and/or Medical Claim Form  

• HealthExtras Blanket Travel Accident & Sickness Claim Form  

• Avis Rent-A-Car Personal Accident Insurance Claim Form
• Avis Rent-A-Car Personal Effects Coverage Claim Form  
• Budget Rent-A-Car Tow Guard Claim Form
• Budget Rent-A-Car Emergency Sickness Protection Claim Form
• Budget Rent-A-Car Cargo Coverage Claim Form
• Budget Rent-A-Car Personal Accident Insurance Claim Form
• Budget Rent-A-Car Personal Effects Coverage Claim Form  
• Generic Emergency Sickness Protection (ESP) Claim Form
• Generic Emergency Personal Accident Insurance (PAI) Claim Form
• Generic Personal Effects Coverage (PEC) Claim Form  

• ACE - NIRA Proof of Loss Form  
• Mutual of Omaha - California Claim Form
• Mutual of Omaha - Generic Claim Form
• Mutual of Omaha - IPRA Claim Form
• Mutual of Omaha - National Little Britches Claim Form
• Mutual of Omaha - NHSRAP Claim Form
• Mutual of Omaha - NHSRAW Wrangler Claim Form
• Mutual of Omaha - PBRP Claim Form
• Mutual of Omaha - PRCA Claim Form
• Mutual of Omaha - WPRAP Claim Form  

• Travel Net - Release and Physician's Statement
• Travel Net - Lost Baggage Claim Form
• Travel Net - Travel Delay Claim Form
• Travel Net - Medical Claim Form
• Travel Net - Trip Cancellation Claim Form  

• AIG Trucking Claim Form
 
• NAIT Trucking Claim Form
• NAIT Passenger Claim Form  

• TPT Disability Claim Form  

• USA Judo Claim Form  

• USTA Disability Claim Form