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AS-00 SCHOLASTIC INSURORS, INC. P. O. Box 3194, Johnson City, TN 37602-3194 GROUP ALL SCHOOL INSURANCE CLAIM FORM PLEASE READ CAREFULLY CLAIM PROCESSING * * See Reverse side * * PART A SCHOOL OFFICIAL.

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How to fill out the SCHOLASTIC INSURORS online

Filling out the SCHOLASTIC INSURORS claim form is an essential step in processing an insurance claim for a school-related injury. This guide provides clear, step-by-step instructions to ensure that all necessary information is collected accurately and efficiently.

Follow the steps to complete the SCHOLASTIC INSURORS claim form.

  1. Press the ‘Get Form’ button to access the SCHOLASTIC INSURORS claim form and open it for editing.
  2. Complete Part A of the form by providing the name of the school, the school system, and the school address. Ensure that all required fields are filled in accurately.
  3. Enter the name of the injured student, along with their grade and age. Make sure to include all parts of their name (first, middle, last).
  4. Record the date and time of the injury. Ensure that this information is precise to avoid any processing issues.
  5. Specify under whose supervision the student was at the time of the injury and fill in the title of that individual.
  6. Indicate the activity during which the accident occurred by selecting the appropriate option: Game, Practice, P.E., Travel, or Other.
  7. Answer whether the student was involved in a school-sponsored and supervised activity at the time of the injury by selecting 'yes' or 'no'.
  8. Provide a detailed description of how the accident happened. Be as thorough as possible to help with the claim assessment.
  9. The school official must sign and date the form to verify the information provided in Part A.
  10. Next, move to Part B, where the parent or guardian must fill out their personal information, including names, Social Security numbers, and addresses.
  11. Indicate the occupations and employers for both parents or guardians, along with their respective employer addresses.
  12. Provide information regarding any other insurance companies associated with the parents or guardians, including policy/group numbers and type (Group, Individual, HMO/PPO).
  13. Read and agree to the Kentucky required statement, acknowledging the terms related to fraudulent claims, and authorize benefit payments as required.
  14. If there was a dental injury, Part C must be completed by the dentist, detailing the injured teeth and previous conditions.
  15. Collect and attach the required itemized bills and insurance statements to the completed form before submitting.
  16. Submit the completed claim form and any supporting documents to SCHOLASTIC INSURORS, Inc. at the address provided in the instructions.

Complete your SCHOLASTIC INSURORS claim form online today for efficient claims processing.

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