iNext Insurance Claim Form Page 1 Participants Information must be completed The Account Name would be Elon University and the Policy Number would be your policy number from your iNext ID card ID: 1015815
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1. Trip Cancellation Claim ProcessiNext Insurance
2. Claim Form Page 1Participant’s Information must be completed. The Account Name would be Elon University and the Policy Number would be your policy number from your iNext ID card.List home address. If you want payment sent to a different address, list on the second address line.Legal Guardian only needs to be completed if the student is under the age of 18.Travel Supplier Information needs to be completed. If the arrangements were not made by a Travel Supplier, but by Elon University directly, Elon would be listed.The Date Travel Protection plan was purchased was the date enrolled into iNext. The Initial Deposit date would be the date initial deposit was made to the Travel Supplier or to Elon University for the program. Elon University may need to provide this information to you.Loss Information is where you will list the Amounts of the Loss and if you received any reimbursement. Items listed will need supporting documents.
3. Claim form page 2Reason for Cancellation must be completed. The date Trip was cancelled with the Travel Supplier would be the date that Elon University was notified, or if a Travel Supplier was used, the date that Elon University notified the supplier.If the Cancellation was due to Medical Reasons, the Attending Physician must complete and sign and provide their Tax-ID number.The Authorization for Release of Medical Information must be signed by you, the participant. This information is needed to file a Trip Cancellation Claim due to Medical Reasons.Trip Cancellations due to medical reasons due have a pre-existing condition exclusion. Please be sure to read the full policy documents on the exclusion and pre-existing condition definition.
4. Claim for page 3Please be sure to send in the required documents when sending in the claim.Proof of Cancellation from the Travel Supplier or from Elon University is required. This document you will need to obtain from Elon University.Verification of payment made to Elon University or to the Travel Supplier is required-you can provide cancelled checks or credit card statementsIf there were any reimbursements received for the program, copies of these documents will need to be provided. These can be from an airline if airfare was covered separately.Copy of the original flight itinerary showing the original dates of travel.Other Insurance/AuthorizationIf additional insurance was purchased, this information will need to be listed.Authorization-the claim form must be signed and dated by you.The completed claim form and all required documentation needs to be emailed to Co-Ordinated Benefit Plans for processing at TravelTeam@cbpinsure.com