• How Do I Submit the Claimant's Statement and Authorization Form?

    You can complete and submit the Claimant's Statement and Authorization form (along with supporting documents) in one of the following ways:

     

    • Via DocuSign within Member Portal (Most Efficient Approach)
      • Go to Member Portal (formerly Client Zone / Student Zone) at worldtrips.my.site.com/MemberPortal.
      • Log in to your account. If this is your first time using Member Portal, view instructions for registering your new account here.

         

        NOTE: If you already have a Client Zone / Student Zone account, you do not need to register for a Member Portal account. Simply log in to Member Portal using your Client Zone / Student Zone login details.


      • Click "Claims and Appeals" in the main navigation menu.
      • Click the “Submit New Claim Via DocuSign” button under the “Claimant’s Statement and Authorization Form” subheader in the “File a Claim” section and follow the instructions.

    For more extensive step-by-step instructions, including screenshots, please see our “How to Submit a Claim” guide.

     


    Don't Have Access to the Claims and Appeals Page?

    If you noted that you are not the insured or the insured’s legal guardian, you will see the Protected Health Information Authorization page in place of the Claims and Appeals page. Enter the insured’s email address and click “Send Request.” Once the insured has completed and submitted our HIPAA form, you will gain access to the Claims and Appeals page and have the ability to submit a claim within 3-5 days.

     


    • Via Online Submit Claim Request Form
      • Download the Claimant's Statement and Authorization form here.
      • Complete and sign the form.
      • Visit www.worldtrips.com/customer-service and select "Submit a claim or appeal for your Atlas Travel, Atlas Premium, Atlas Group, Atlas MultiTrip, or StudentSecure plan" under the "Actions” header.
      • Click the "Submit Claim" button.
      • Fill in the requested information on the Submit Claim Request Form and upload the form, along with additional documentation (medical records, receipts, invoices, etc.).
      • Click "Submit."

                    WorldTrips

    Claims Department

    PO Box 240358

    Apple Valley, MN 55124

    U.S.A.

    WorldTrips is also happy to fax, e-mail, or mail the form(s) to you upon request.

     

    Important Note for Students:

    For eligibility purposes, you must submit the following along with a Claimant's Statement and Authorization form:

    • A copy of your education-related visa (F-1, J-1, OPT, etc.) or valid I-20/DS2019
    • Proof of full-time student status (not necessary if submitting a valid F-1 visa including OPT, or J-1 visa)