How to Submit a Claim: Step by Step Guide
*If you experience multiple illnesses, please submit a claim form for each illness. For example, if you experience a sinus infection and suffer later from gastrointestinal issues, you will need to submit two claim forms.
Here are additional forms you may need to include depending on your claim:
Non-U.S. Claim Form
- If you are submitting a claim outside the United States, please fill out and include the Non U.S. Claim Form
Dental Claim Form
- Submit if you have a claim that requires dental care
- Submit in addition to your claim form if you were injured during an accident (such as falling, sports injury, motor vehicle accident, etc.)
Trip Cancellation Series
- Submit if you purchased Trip Cancellation coverage and experienced an unexpected situation involving your trip.
1. Click on “Claimant’s Statement.”
If you are submitting a claim for a Short Term Medical Plan (STM) please select your state before downloading the appropriate form(s)
2. When the claimant’s statement (or other form) is open, click the download button in the top right hand corner. It will look like a piece of paper with an arrow pointing down as shown below:
3. Fill out the form completely by printing and filling out by hand, or you may fill it out on your computer if possible.
4. Go to www.hccmis.com and visit the customer service tab near the upper-right corner. You can go there directly by visiting http://www.hccmis.com/customer-service/
5. Click the “go to claims” arrow on the customer service page
6. Fill out all information in the claims help request and upload the completed Claimant’s Statement from steps 3 and 4.
*Include the Non U.S. Claim Form (from Step 1) if your claim is outside the United States