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Submitting Claims

Have receipts for eligible expenses after the effective date of your plan? Learn how to get reimbursements.

Emergency Health Insurance Plan Claim Form

To submit a claim, you will need to download and complete the form, and ensure the form is signed and dated before submitting to Intrepid 24/7™. Please include any documents to support your claim. You must email your documentation to Intrepid 24/7™ at :

You must include a copy of the emergency room report and all hospital records if the treatment was received at a hospital. Remember to keep a copy of all documents emailed for your records.

Download the International Emergency Health Insurance Plan Claim Form


  • All claims must be reported to Intrepid 24/7™ with 30 days of occurrence.
  • Written proof of claim must be submitted to Intrepid 24/7™ within 90 days of occurrence.
  • You are responsible for all fees charged for any supporting documentation.
  • Failure to complete and sign the form in its entirety or submit supporting documentation will delay claim processing.

How to submit claims

  1. Complete a Claim form
    • Download the Claim form
    • Complete the form electronically or print and fill out each section
    • Fill out all required fields
    • Once complete, print completed form, Sign and Date in Pen (all claim forms must be signed and dated to be processed)
  2. Gather your information related to your medical visit
    • Collect all medical reports, documents, ER Tests, Referrals, follow up required; Confirmation of Receipt(s); anything that you received during your appointment
    • Make a clear photocopy of your documents and scan (keep your originals)
  3. Submitting the Claim:
    • Submitting a claim form when has requested that you complete one following a direct billing submitted on your behalf; or
    • Submitting a claim form when you have paid out of pocket for your medical visit.
    • Once your form is completed and applicable documents copied, email them at
  4. Follow up Status:
    • Check your email for follow up documentation from that may be required by the Claims Department to process your claim. They will explain to you exactly what is missing from your submission.
    • Provide any requested information as soon as possible.
    • Call 1.866-883-9485 if you have any questions about your claim or to clarify what else is needed
    • Follow up email:
    • If your claim is denied, an explanation about the exclusion(s) will be provided by email.

Tip* Before leaving the clinic, or medical visit request a copy of your medical records, tests, referrals, follow up or doctors notes that were applicable. This will help in processing your claim, otherwise Studyinsured/Insurer will have to request you to complete an authorization form signed by you to obtain your medical records to process your claim.

Monday-Friday, 8am-6pm EST
Phone: 1-877-746-5566 ext. 7249

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