To Submit an Insurance Claim:

1. Download and print form Download
2. Gather all paid medical bills (if you have any at this point)
3. Fill out the form (as soon as possible once an incident occurs)
4. Submit claim form and bills (you can submit bills later as well)
5. Email to Mark Menconi at [email protected]
   
6. Mark will submit the claim form to our supplemental medical coverage carrier.
7. You can submit bills as you go along in the process directly to the insurance company
8. You can email Mark directly if have any questions regarding the form.