Vehicle Claims Reporting Form (PDF)


Building and Contents Property Claims

Reporting Losses

  1. Report loss by:
    Submitting a completed Potential Property Claim Form (DOC) to Risk Management
    When claim involves a crime, also notify the UK Police Department.
    When claim involves damages greater than $10,000, contact Risk Management by phone or email ASAP
  2. Take necessary steps to prevent further loss or damage
  3. Provide all supporting documents; purchase documents, repair estimates/invoices, replacement quotes, photographs of damages, police reports, etc.
  4. Send the above to the attention of: Todd Adkins

Excess Accident Medical

Explanation of New Claims Processing University of Kentucky Camps Insurance Program

Part I of the Claim Form should be completed by the Camp Director or other Supervisor. This section of the Claim Form simply documents to the Insurer that an accident or illness has occurred. A copy of the claim form should be kept at the camp for their records. Once Section I is completed by the Camp Director or Supervisor, the form should be given to the camper for completion. Please note: the Claim Form should not be given to the camper until expenses are incurred.

Part II of the Claim Form should be completed by the camper/claimant or his/her parents. The information given in this section is very important because it will drive the rest of the claims process. If the camper/claimant has primary insurance, copies of the Explanation of Benefits (EOB) forms need to be included with the completed claim form and fully itemized medical bills.

If the camper/claimant does not have primary insurance, no EOB will be available. Therefore, just the completed claim form and copies of fully itemized medical bills need to be sent to the Claims Processor, AGIA. Please note: Make sure to instruct the camper/claimant that balance due bills are not acceptable in lieu of itemized medical bills. 

The Authorization to Release Information and Payment Authorization contained within Part II of the Claim Form must be signed by the parent or camper/claimant before the claim form is mailed to AGIA.

As referenced above, once the Claim Form has been completed and authorized, the Claim Form, fully itemized medical bills (and EOB's if applicable) should be sent to AGIA at the address listed at the top of page one of the Claim Form. As soon as a Dedicated Claims Examiner has been assigned to the plan, his or her name and number will be made available to you in the event of a question on the status of a specific claim.

Claim Form (PDF).