If you are interested in purchasing participant accident coverage for your group, click here.
If you need to file a claim:
If you have an accident or injury, you will need to submit a claim form to the Special Risk Claims Department. Click here for claims forms and instructions.
When should I file a claim?
- Written notice of a claim must be received within 20 days of a loss or injury.
- Written proof of the loss or injury (the completed claim form and supporting documents) must be submitted to the Special Risk Claims Department within 90 days of the occurrence.
How do I complete the claim form?
- Answer all questions in full for efficient claims processing.
- An official of the plan sponsor's organization (for example, your coach, group leader or league sponsor) must complete and sign Section I.
- The insured (parent or guardian if the insured is a minor) must complete Section II.
- Date and sign Section III (optional).
- Attach itemized bills showing the (a) patient’s name, (b) diagnosed condition, (c) date(s) of treatment, (d) nature of treatment and (e) charge per treatment.
Send all documentation to the Special Risk Claims Department at the address or fax number listed below:Mail:
Nationwide Specialty Health
PO Box 420
Springfield, MA 01101
To contact Customer Service:
Telephone: (800) 525-8669 Monday – Friday 8:00 am – 5:00 pm ET