Nahga claims services 2026

The document is a claim form for student insurance provided by NAHGA Claim Services. It outlines the necessary steps for submitting a claim, including the requirement to first submit to any other medical insurance if applicable. The form collects detailed information about the policyholder, insured student, injury details, and parental or guardian information. It also includes an authorization section for the release of medical information and payment of benefits directly to healthcare providers.

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Click ‘Get Form’ to open it in the editor.
Begin with Part 1: Policyholder & Insured. Fill in the school/organization name, policy number, and student details including last name, first name, and social security number.
Complete the mailing address section and provide the city, state, zip code, birthdate, gender, phone number, date and time of injury, and location of the injury.
Indicate how the injury occurred and specify if it was during a supervised activity. Include details about the sport designation and type of sport.
In Part 2: Parent or Guardian Statement, enter both parents' names and contact information along with their employers' details.
Confirm if the student has other insurance coverage and provide the insurance carrier's name if applicable.
In Part 3: Authorization, read through the authorization statement carefully. Sign and date where indicated to authorize information disclosure for claim processing.

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