Claims Information

For every new injury and illness you have (even if the provider is billing directly to the claims team), you will need to submit the following documents:

1. Fully completed claim form. You will also need to complete the accident form if your visit to the doctor was the result of an accident. (download links below)
2. Copy of photo page of your passport
3. Copy of your I-20 or DS2019, if applicable
4. Copy of your visa in your passport

We recommend that you scan all these documents, or take a picture with your phone, and email them to the claims team for faster processing. They can be emailed to CustomerCare@imglobal.com.

Main Claim Form

Injury Accident Claim Form