Process to follow for all Claims

  1. Download and complete the appropriate Claims Form
  2. Attach copies of all the pages of the passport
  3. Attach the itemized bills
  4. Submit the above within the stipulated time (Most companies have a 90 day limit after seeing the provider)
  5. Follow up on your Claim by calling the appropriate Claim Number
It is a good practice to keep a copy of the entire Claims documents with you before you submit the Claims for processing.


Claim Form for Patriot Plans

If you have paid bills for any treatment and need to be reimbursed for the out of pocket expenses, please download and submit the completed form along with the itemized bills to the address below. For timely claims settlement, please make sure the claims form is submitted within 90 days of seeing the provider.

International Medical Group Claims Department
PO Box 88500
Indianapolis, IN 46208-0500
Claims Number: 1.800.628.4664

Claim Form for Atlas & Visitor Secure plans

If you have seen a provider any illness or injury please download and submit the completed form along with the itemized bills (if you have paid) to the address below. For timely claims settlement, please make sure the claims form is submitted within 90 days of seeing the provider. Please make sure you submit this form even if you have not paid for the expenses. Claims settlement can begin only after this form has been submitted.

HCC Medical Insurance
P.O. Box 2005
Farmington Hills, MI 48333-2005
Claims Number: 1.800.605.2282

Claim Form for Inbound & Liaison plans

To submit a claim, download the form by clicking above. The completed claim form along with itemized bills that have the claimant's name and nature of injury or illness should be sent to the address below. The form must be signed and dated, and submitted for consideration within 90 days of the date of service.

Seven Corners
303 Congressional Boulevard
Carmel, IN 46032
Claims Number: 1.800.335.0477