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The College
Claim Form appears below in Adobe Acrobat PDF format to be downloaded.
It is a one-page
form
- If you have other
insurance, file your claim with the other carrier first. Keep copies of everything
you send them, and copies of the Explanation of Benefits forms they send
back to you.
- Then, be sure to fill in
this claim form.
- Be sure to check the name
of the correct Underwriting Company at the top of the page. Commercial Travelers
processes claims for its own policies and for two other companies. If
you don't know the name of the company underwriting your coverage, check
with the Student Health Office.
- Complete the form with all
the related information about your accident or illness.
- Attach itemized bills from
this accident or illness, and any paperwork from other insurance
companies.
- Print the completed claim
form.
- Sign the form, and
mail or fax it and the bills to us for prompt processing. ( e-mailed
copies of the claim form will not be accepted)
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Mail to:
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College Claim Department
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Commercial Travelers Mutual Insurance Company
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70 Genesee Street
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Utica, NY 13502
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- Or, for even faster
service- fax to: 315/797-0195
If you have any questions,
please call between 8:30 am and 4:00 pm Eastern Time: 800/756-3702
(College 1-page
Claim Form)
You must have
Adobe Acrobat PDF viewer to view and print this form.

(Free Download)
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from any location in the United States, send us an E-mail message, or fill
out our Inquiry Form.
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1996-2000 by Commercial Travelers Mutual Insurance Co.
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