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Claim Filing Information

Claim forms are required for the first claim of each school year and all accident claims. Obtain claim forms from the student insurance office located in Bishop Wellness Center. Students seeing a provider outside the Bishop Wellness Center must obtain a referral from Health Services. Our office can assist the student in filing a claim.

Coverage information to give a provider for billing school insurance is provided below.

2009-2010 School Year:

2009-2010 Insurance Carrier
Fairmont Specialty
Claims Sent To
NAHGA Claims Services
Billing Address
PO Box 189
Bridgton, ME 04009
Group Number
US035686-09B0424
Coverage Dates
August 15, 2009 through August 14, 2010
Insured ID
Student ID number
Insurance Phone Number
1-800-952-4320
Insurance Fax Number
1-207-647-4569
Insurance Email
      eiia@nahga.com
Claim Form  (pdf)   

Fill out the claim form and print. Bring to the Willamette University Student Insurance office to be signed off before mailing to NAHGA.