For AD&D, International Pathfinders, and Adventist Service Volunteers effective April 1, 2009 use ACE claim forms for accidental death, dismemberment, accident-medical, sickness diagnosed for the first time, and accidents that occur on or after April 1, 2009. (Sickness would apply only to Adventist Service Volunteers)
Please use the Chartis Short Term Travel (STT) claim forms for STT coverage purchased on or before
December 31, 2012.
ACE Accident & Sickness Medical
ACE Accidental Death (AD&D)
ACE Accidental Dismemberment (AD&D)
ACE Short Term Travel Accidental Death (AD&D)
ACE Short Term Travel Accidental Dismemberment (AD&D)
ACE Short Term Travel Accident & Sickness Medical
ACE Short Term Travel Personal Effects & Money
ACE Short Term Travel Trip Cancellation Interruption
Chartis
Short Term Travel - Accidental Death
Chartis
Short Term Travel - Baggage
Chartis
Short Term Travel - Medical
Chartis
Short Term Travel - Trip Cancellation
Adventist Colleges Abroad (ACA)
Boiler Equipment Breakdown (
contact Claims for form)
Global Accident and Sickness - AIG/Chartis
English -
French
Death Claim - Chartis
Executive Risk Guidelines
Alico Global Basic Life
Householders -
English -
Spanish
International Workers Compensation - First Report of Injury or Illness
International Liability -
English -
French -
Spanish -
Italian -
German
Miscellaneous Accident Medical - Chartis
NAD Automobile Loss
English -
Español
NAD Liability Loss
NAD Premises Medical
NAD Property Loss
Ocean Marine
International Campers - Chartis
Personal Effects Baggage -
English -
Spanish
International Property -
English -
Spanish -
French -
German -
Portuguese
Survivor Benefits - Africa - Chartis
Temporary Total Disability - Chartis
Volunteer Labor -
Medical -
Dismemberment -
Death -
Lost Wages
Français
Campeurs-Preuve de Sinistre.doc
FORMULAIRE AVIS DE DÉCÈS Fond International de Garantie de Prestations au Survivant.doc
FR-STT-Formulaire Indemnisation Accident et Maladie / Global.doc
FR-STT-Formulaire-Réclamation-Bagage-Perte, Vol, Détérioration.doc
FR-STT-Formulaire- Annulation de voyage/interruption/retard.doc
FR-STT-Preuve de Sinistre-Décès Accidentel.docx
FR-VL-Preuve de Sinistre - Décès Accidentel.doc
FR-VL-Disability-Claim_Form-20120625.docx
FR-VL-Dismemberment-Claim_Form-20120625.docx