Claims

To file a new claim or view claims already filed visit the website provided here.


ACI Claim Status Website

RCM&D can assist travelers with claims. We will need you to complete and sign an authorization form to allow us to contact the Insurance Company on your behalf.


HIPAA Authorization Form (PDF) How to File a Medical Claim Form
Reference Sheet

To submit a claim, please download and fill out the PDFs provided here.


Medical Claim Form (PDF) Trip Cancellation / Interruption Form (PDF)