Claim Instructions

1. After you receive treatment, download and complete this insurance claim form with your information and this policy No. DSP00026-08.

2. Mail the claim form and all medical and hospital bills to:
   
   Personal Insurance Administrators, Inc.
   P.O. Box 6040,
   Agoura Hills, CA 91376-6040

3. A claim must be submitted within 90 days after an injury or Sickness has occurred in order for the claim to be paid.

4. If you have questions about the status of your claim after it has been submitted, call 1-800-468-4343 and specify the policy No. DSP00026-08.

Click here to see 2007/2008 claim procedures.