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Claim Forms

Submit Medical Claim Forms to:
Administrative Concepts Inc.
994 Old Eagle School Rd.
Suite 1005
Wayne, PA 19087

   1.888.293.9229 (for all inquiries)
1.610.293.9299
www.visit-aci.com

• Chartis Medical Claim Form
• Ace Medical Claim Form
• Chartis Medical Claim Form

 
Submit CHARTIS Accidental Death and Dismemberment Claim Forms to:
CHARTIS Accident & Health Claims Department
P.O. Box 25987
Shawnee Mission, KS 66225-5987

  1.800.551.0824
1.866.831.3636

• Chartis Accidental Death Claim Form
• Chartis Accidental Dismemberment Paralysis Claim Form

 
Submit your ACE Accidental Death and Dismemberment Claim Forms to:
ACE American Insurance Co
1 Beaver Valley Rd
PO Box 15417
Wilmington, DE 19850

• ACE Accidental Death Claim Form
• ACE Accidental Dismemberment Paralysis Claim Form

   1.800.336.0627
1.302.476.6154