How to File A Claim
Do you have any other coverage? This plan is second payer after family group coverage. Student Insurance will consider balances which remain after the primary insurance has processed the claim.
Your claim will be coordinated so that you have the maximum coverage utilizing two or more plans.
To file a claim with other coverage, submit:
- A completed Chickering Claim Form (requires Adobe Acrobat Reader Click here to download ) or visit the Student Insurance Office.
- An itemized bill from the provider of the service. Accepted forms are HCFA 1500 from a physician; UB92 from a hospital.
- An explanation of benefits from your other insurance carrier(s).
OR
Is this your only coverage? If you have no other coverage, ISU Student Insurance will act as your primary carrier.
To file a claim without other coverage, submit:
- A completed Chickering Claim Form. (requires Adobe Acrobat Reader Click here to download) or visit the Student Insurance Office.
- An itemized bill from the provider of the service. Accepted forms are HCFA 1500 from a physician; UB92 from a hospital.
All claims and requests for information should be directed to:
Illinois State University
Student Insurance
Campus Box 2541
Normal, IL 61790-2541
Phone: (309) 438-2515
Fax: (309) 438-3875
