
PROOF OF CLAIMThere is a timely filing period of one year and ninety days. Do not wait to send information as this may result in claim denial.Mail, Fax or Email completed form to: STUDENT ASSURANCE.
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How to fill out the MN SAS CLM-3 online
Filling out the MN SAS CLM-3 form is essential for submitting a claim regarding college-related accidents. This guide provides clear, step-by-step instructions to help users complete the form accurately and efficiently.
Follow the steps to complete the MN SAS CLM-3 form online.
- Click the ‘Get Form’ button to obtain the claim form and open it in your preferred online editor.
- Complete Part A: A college official must fill out this section, including the name of the college, college address, and their signature along with the date and title.
- Proceed to Part B: The insured student should input their name, address, phone number, email, date of birth, and student ID. They must also indicate their employment status and provide the name of their employer if applicable. Additionally, confirm if they have insurance coverage and specify the insurance company.
- If applicable, fill out Part C: This section should be completed by the student's parent or guardian, including their name, contact information, occupations, and insurance coverage details.
- Review all sections to ensure accuracy and completeness. Each participant in the form must sign in their respective sections to validate the information provided.
- Prepare your submission: Gather the completed claim form along with the required itemized bills and any Explanation of Benefits from other insurance providers.
- Submit your claim: You can email, fax, or mail the completed form and necessary documents to Student Assurance Services, Inc. Ensure all documentation is provided to prevent delays in processing.
Complete your MN SAS CLM-3 form online today to ensure timely processing of your claim.
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