How to Submit a Claim Form

1. When an injury is school-related, a School Administrator
    must complete and sign PART A of the claim form.
      a. Select "Claim Form" below.
      b. Complete PART A of the claim form. To avoid processing
           delays, answer all questions pertaining to the school-
           related injury.
      c. Sign or type the school official's name in PART A of the
           claim form.
      d. When PART A is completed, save and print a copy of the
           claim form for your records.
      e. Mail, fax or email the completed claim form to:
              Student Assurance Services, Inc.
              P.O. Box 196, Stillwater, MN 55082;
              Fax number: (651) 439-0200
              Email: claims@sas-mn.com

    Note: if faxing, include a cover sheet with your name and
    contact information.

2. If possible, email or send the completed PART A claim form
    to the student to complete PART B and C of the claim form.
           Click here for Texas public schools claim form
           Click here for all other schools claim form


Student Bills and Other Documentation
The student is responsible to submit itemized bills and any other supporting information (such as other insurance EOBs, letters, reports) to us. If you have any of this information, you can email, fax or mail it to:
              Student Assurance Services, Inc.
              P.O. Box 196, Stillwater, MN 55082;
              Fax number: (651) 439-0200
              Email: claims@sas-mn.com

Note: Policies have timely filing deadlines, so please
          submit the claim form as soon as possible.

Mailing Address:
Student Assurance Services, Inc.
P.O. Box 196
Stillwater, MN 55082

Customer Service:
Toll Free (800) 328-2739
Fax (651) 439-0200

Email to submit a claim:
claims@sas-mn.com