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How to use or fill out Student Accident Claim Packet - Barnegat Township School
- Click ‘Get Form’ to open the Student Accident Claim Packet in our editor.
- Begin with Part 1A - Policyholder. Fill in the College/University name, policy number, student’s name, date of birth, and details about the injury including the date and type of sport or activity.
- In Part 1B, provide the injured person's information such as their Social Security Number, home address, phone number, and email. Ensure to indicate if they have other insurance coverage.
- Complete the Parent/Guardian Information section by entering names, contact details, and employment status for both parents or guardians.
- Review the Medical Information Authorization & Assignment of Benefits section carefully. Sign and date where indicated to authorize information sharing with BMI Benefits.
- Finally, ensure all sections are completed accurately before submitting your claim within 90 days from the date of accident.
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