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Community Orientation
Medical Claim Procedures
To request reimbursement for expenses, you will
need a copy of the medical insurance claim form. This claim form
must be completed in full, and submitted to the claim office with complete
documentation. On the top of the form, you must include the group
insurance company name and policy number listed below: Combined Insurance
Company of America. The policy number is GLB 9709600 (0810-2539) (06).
Claim Procedures:
In the event of an injury or sickness, the insured person should:
- Consult a doctor and follow his/her advice.
- Submit your insurance claim form within 30
days of the accident or illness.
- Complete the claim form in full with all the
related information requested regarding your illness. Make sure to sign and
date the claim form.
- Attach all bills from the accident or
illness, and any paperwork from your doctor, the hospital and/or other
insurance companies.
For prescription drug claims, attach the
itemized doctor/hospital bill along with the receipt from the pharmacy for
the drug, along with the name/description of drug.
Mail Claim Form to:
AMA and Associates
P.O. Box 659570
San Antonio, Texas 78265-9570
Telephone: 1-800-456-7480
Fax: 1-210-822-4113
Local Office:
Westpoint Insurance Company
5625 West 79th Street
Burbank, IL 60459
(800) 318-7709
Fax (708) 636-3915
E-mail:
terri@westpointinsurance.com |
