HCC Medical Insurance Services

	Phone: 1-800-605-2282 Every day, 24 hours per day
	E-mail: service@hccmis.com
	Mail:                                                                       HCC Medical Insurance Services                                 P.O. Box 2005                                                         Farmington Hills, Michigan 48333

If you are submitting a claim for a Short Term Medical Plan (STM) please select your state before downloading the appropriate form(s).

If you experience multiple illnesses, please submit a claim form for each illness. For example, if you experience a sinus infection and suffer later from gastrointestinal issues, you will need to submit two claim forms.

Depending on your claim, you may also need one or more of the following forms:

Non-U.S. Claim Form - If you are submitting a claim outside the United States, please fill out and include the Non U.S. Claim Form
Dental Claim Form - Submit if you have a claim that requires dental care
Accident Questionnaire - Submit in addition to your claim form if you were injured during an accident (such as falling, sports injury, motor vehicle accident, etc.)
Trip Cancellation Series - Submit if you purchased Trip Cancellation coverage and experienced an unexpected situation involving your trip. 

- See more at: http://www.hccmis.com/customer-service/claims-guides/claims-guide-english.html#sthash.VkG0leU2.dpuf