Submit a Claim

How to Submit a Claim Form

When an injury is school-related, a School Administrator should complete and sign PART A of the claim form.

select "Claim Form" below;
complete PART A of the claim form. To avoid processing delays, answer all questions pertaining to the school-related injury;
sign or type the school official's name in PART A of the claim form;
when PART A is completed, save and print a copy of the claim form for your records;
mail, fax or email the completed claim form to:
Student Assurance Services, Inc.
P.O. Box 196, Stillwater, MN 55082;
Claims Fax: (651) 439-0200
Email: claims@sas-mn.com

Note

If faxing, include a cover sheet with your name and contact information.

If possible, email or send the completed PART A claim form to the student to complete PART B of the claim form.

Texas Public Schools Claim Form Other Schools Claim Form Texas Public Schools Online Claim Form Other Schools Online Claim Form

Student Bills and Other Documentation

The student's parents or guardians are responsible to submit itemized bills and any other supporting information (such as other insurance EOBs, letters, reports) to us. If you have any of this information, you can email, fax or mail it to:

Student Assurance Services, Inc.

P.O. Box 196, Stillwater, MN 55082
Claims Fax: (651) 439-0200
Email: claims@sas-mn.com

Note

Policies have timely filing deadlines, so please submit the claim form as soon as possible.