Submitting a claim has never been easier!

Our NEW eClaims application walks you through the process step by step.

eClaims saves you time by guiding you, asking only the questions that your claim requires.

Claims Status

To check the status of an Accident Claim, please complete our online form.

How It Works

	1. Enter your claim information
	2. Print out a pre-filled claim form
	3. Have the coach sign the claim form
	4. Mail the claim form to the address at the top left of the claim form

Blank Claim Form

If you would like a blank claim form, please select your accident date below and then press “Print Blank Claim Form”.

*Accident Date

Instructions:

Complete the claim form
Have it signed by the coach
Mail it to the address in the top left corner

BollingerLax. Count on us for more.