Student Accident Claim Forms

This coverage is secondary to the child’s primary coverage. This means that if the child is covered through their parent’s plan, that plan will pay benefits first then, if necessary, this plan will kick in.

The district is not involved in the processing of these claims. The parents must work directly with the insurance provider regarding any and all claims. Our obligation for handling ends after we have completed the top section (Part 1-A)of the form.

GLIC Student Accident Insurance Claim Form (signed claim form is required)

GLIC Voluntary 24-Hour & Dental Student Accident Instructions

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