How to File a Claim

(All Plans)

As with ordering insurance, you may NOT submit the claim directly to the insurance company. Follow the steps below.

Steps for Filing a Claim:

Print out the claim form • Español

Visit Mutual of Omaha’s website for more information on the claim process.

  1. Print out all 3 pages of the claim form and staple together.
  2. Complete the form in full and sign wherever appropriate. Do not complete the very bottom section (for council use only).
  3. Send the claim form to the risk management and travel assistant at the GSNorCal Alameda Office for validation, along with any bills received at the time.

Girl Scouts of Northern California
Attn: Risk Management and Travel Assistant  (Confidential)
1650 Harbor Bay Parkway, Suite 100
Alameda, CA 94502

  1. The council receives the completed claim form and reviews for membership status or purchase of Optional Insurance, eligibility, presence of a bill, and that the activity information provided is sufficient to confirm the claim is for a Girl Scout-related accident or illness.
  2. The council will complete the council section, sign and mail to the insurance company for processing.
  3. The process can take 4-6 weeks once the bill is submitted to Mutual of Omaha.
  4. Send any subsequent bills related to this claim to the risk management and travel assistant at the council office until directed to send directly to the insurance company.

Questions

Please contact the Risk Management and Travel Assistant at (510) 562-8470 ext. 1108 or Insurance@GirlScoutsNorCal.org


IMPORTANT NOTICE

Your Girl Scout coverage is secondary to any health insurance you have. Submit your claim to your primary health insurance company first. When you receive an Explanation of Benefits Statement, send it along to us with our itemized bill and the completed claim form. Payment will be made to the providers of service (Hospital, Physician or Others), unless a paid receipt statement accompanies the bill at the time the claim is submitted.