How to File an Accident Insurance Claim

To Download and Print an Accident Insurance Claim Form, Click Here

If you are accidentally injured and require medical treatment, you must receive treatment by a licensed doctor of medicine within 90 days from the date of your accident to be eligible for policy benefits. You must complete a claim form and forward the completed form to Lawrence E. Smith and Associates, Inc., the agency that processes claims,  along with copies of your doctors, hospital or any other medical bills.  If you have access to other insurance, you must also file a claim with your primary insurance source and submit a copy of information received from your other primary insurance indicating the amounts that they will pay or the reasons why they are not paying any benefits to you.

Important: In order to be eligible for policy benefits, you should submit a completed accident insurance form to Lawrence E. Smith and Associates, Inc. within 90 days from the date that you were injured.  Claim forms that are received later than one year from the date of accident will be rejected and you will not be eligible for policy benefits.

 

Knox College Accident Insurance Claim Form
Knox clm form 2012 .pdf
Adobe Acrobat document [26.4 KB]