Contact: (510) 987-9832

 


University of California Traveler Insurance Claims Forms

To make a claim, complete these forms and provide them to the contact person on the form.

UC Employee Claims Forms

  • Foreign Travel Accident and Sickness Claim - Word - PDF
  • Accidental Dismemberment Claim - Word - PDF
  • Travel Disability Claim - Word - PDF
  • Travel Accidental Death Claim - Word - PDF
  • Loss of Personal Effects and Money Claim - Word - PDF
  • Trip Cancellation/Interruption Claim - Word - PDF

UC Student Claims Forms

  • Travel Accident and Sickness Claim - Word - PDF
  • Accidental Dismemberment Claim - Word - PDF
  • Travel Accidental Death Claim - Word - PDF


Return to UC Business Travel Insurance Page

Questions? Contact Risk Services at (510) 987-9832

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