Blank Texas Clm 2 PDF Form

Blank Texas Clm 2 PDF Form

The Texas Clm 2 form is a Student Accident Claim Form designed for parents and guardians to report injuries sustained by students during school-related activities. This form is essential for filing claims with the insurance provider, ensuring that medical expenses related to the injury can be addressed. For assistance in completing the form, please click the button below.

The Texas Clm 2 form serves as a vital tool for parents and guardians seeking to report and claim benefits for student accidents that occur during school-related activities. This form is divided into two main sections: the first section is intended for completion by a school official, while the second section must be filled out by the parent or guardian. In the first section, essential details such as the name of the school, the injured student's information, and specifics about the incident—including the time, location, and nature of the injury—are documented. The second section requires the parent or guardian to provide personal information, insurance details, and an authorization for the release of medical information. It is important to note that the school is not responsible for medical payments; rather, this form facilitates claims under a supplemental accident insurance policy that may cover costs exceeding a family’s primary insurance. The process emphasizes the need for timely submission within 90 days of the injury and outlines the steps to ensure that all necessary documentation is provided to support the claim. Understanding the components and requirements of the Texas Clm 2 form is crucial for navigating the claims process effectively.

Document Sample

STUDENT ACCIDENT CLAIM FORM

SUBMIT CLAIM FORM TO: Fidelity Security Life Insurance Company c/o Universal Fidelity Life Insurance Company P.O. Box 304

Duncan, OK 73534-0304 (800) 366-8354

Section 1 - Notice of Injury

(To be completed by School Official)

 

 

(This section may be completed by parent if 24-Hour coverage was purchased and accident is not school-related)

Name of School District:

 

 

 

 

Name of School:

 

School Phone No:

 

Name of Injured Student:

Male

Female

Grade:

Date of Injury:

Time of Injury:

AM

PM

Part of Body Injured:

 

Right Side

Left Side

Under whose supervision?

Was accident witnessed?

Yes

No

If "Yes", by whom?

The accident happened while the student was participating in:

Interscholastic UIL Activity

 

Non Interscholastic UIL Activity

Specify Sport/Activity:

Explain in detail how and where the injury occurred: ___________________________________________________________________________

__________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________

Signature of School Official: ________________________________________________________________________________________________

 

 

(Title)

(Date)

IMPORTANT INFORMATION ON REVERSE SIDE

 

Section 2 - Parent/Guardian Statement (To be completed by Parent/Guardian)

 

Name of Student:

Date of Birth:

Home Phone No:

 

Is student covered by any insurance plan? Yes No

If yes,

Policy No.

 

Parent/Guardian Name:

 

Relationship to Student:

 

Address: _________________________________________________________________________________________________________________

(Street)

(City)

(State)

(Zip)

Father's Name:

Father's Employer:

 

 

Name of Father's Insurance Company (must be completed - If Father has no insurance - write "None"):

Insurance Company:

Policy No.

Mother's Name:

Mother's Employer:

Name of Mother's Insurance Company (must be completed - If Mother has no insurance - write "None"):

Name of Insurance Company:

Policy No.

I hereby authorize any insurance company, their authorized agent, hospital, physician, employer, school official or other person who has attended or examined the claimant to disclose when requested to do so all information with respect to any injury, policy coverage, medical history, consultations, prescription or treatment, and copies of all hospital or medical records, and itemized bills. A photo static copy of this authorization shall be considered as effective and valid as the original. I swear that the above information is true and correct to the best of my knowledge. I further understand that any person who knowingly presents a false or fraudulent claim for payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison.

__________________

_____________________________________________

______________________________________________________

(Date)

(Print Name of Student)

(Signature of Parent/Guardian)

Form CLM-2 (10)

 

 

ATTENTION PARENTS

Dear Parents,

Below are instructions for filing the Claim Form. Should you have any questions, contact the school trainer or call the number listed below. The school is NOT responsible for medical payment for your child. The school may have purchased a supplemental Accident Only Policy which may cover charges in excess of your own insurance policy. If you have no other insurance for your child, this policy may pay first or primary. This is a limited benefit policy and may not cover all medical bills for your child. Any charges not covered are YOUR RESPONSIBILITY.

For all school-related accidents, be sure to contact the school trainer or administrator.

INSTRUCTIONS FOR FILING THE CLAIM FORM

Section 1 must be completed by a school official for all school-related accidents and by the parent / guardian if 24-Hour coverage was purchased and the accident is not school-related.

Section 2 must be completed by the parent / guardian.

How to File A Claim

Step 1 - Complete and submit the claim form to the Claims Office at the address indicated below or send electronically to [email protected]. The claim form must be submitted within 90 days from the date of injury regardless of whether you have other insurance or not. Keep a copy of the claim form for your records and present a copy of the claim form to the provider or facility. DO NOT RELY on the provider or facility to submit the claim form.

Submit copies of itemized bills to the address indicated below. Itemized bills are original bills you receive, not monthly statements. Itemized bills are often called UB92 or HCFA1500 forms that provide the procedure code, diagnosis code, and the Providers’ address and Tax ID Number.

Step 2 - File a claim with your primary insurance first. insurance is your family and/or group insurance coverage.

Submit copies of all bills to your primary insurance first. Your primary The school’s policy is supplemental to all other valid coverage.

Step 3. After receiving payment or copies of Explanation of Benefits (EOB) from your family and/or group insurance, submit a copy of this claim form along with copies of your itemized bills and EOBs from your primary insurance company to the address below:

Fidelity Security Life Insurance Company c/o Universal Fidelity Life Insurance Company

P.O. Box 304

Duncan, OK 73534-0304

(800) 366-8354

Texas Kids First has unique access to one of the most creative innovations in the insurance industry – the Texas Kids First Provider Network (TKF Network)* – the first “no balance bill” non-profit network of providers in the State. The network consists of medical professionals and hospitals that have agreed to treat injured students from our insured districts for the services paid and outlined in the Schedule of Benefits of the Texas Kids First Student Accident Plans when the student patient has no other insurance.

Please refer to the website www.texaskidsfirst.com or call 1-800-366-8354 for a list of contracted providers in your area and to verify full assignment acceptance.

*The TKF Network is made available by Texas Kids First and is not affiliated with Fidelity Security Life Insurance Company.

FRAUDULENT CLAIM DISCLOSURE

Any person who knowingly presents a false or fraudulent claim for payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison.

Form CLM-2 (10)

File Specifics

Fact Name Details
Form Title Student Accident Claim Form
Submitting Company Fidelity Security Life Insurance Company
Submission Address P.O. Box 304, Duncan, OK 73534-0304
Contact Number (800) 366-8354
Completion Requirement Section 1 must be completed by a school official; Section 2 by a parent/guardian.
Filing Deadline The claim form must be submitted within 90 days from the date of injury.
Insurance Coverage Parents must file with their primary insurance before submitting to the school’s policy.
Governing Law Texas Insurance Code governs the claims process for this form.

How to Use Texas Clm 2

Filling out the Texas Clm 2 form is an important step in processing a student accident claim. Follow the steps carefully to ensure that all necessary information is provided. Once the form is completed and submitted, the claims office will review it to determine eligibility for coverage based on the details provided.

  1. Begin with Section 1, which must be completed by a school official. If 24-hour coverage was purchased and the accident is not school-related, a parent or guardian can fill this section out.
  2. Fill in the Name of School District and Name of School along with the School Phone No.
  3. Enter the Name of Injured Student, select the gender, and provide the Grade.
  4. Record the Date of Injury and Time of Injury, indicating whether it was AM or PM.
  5. Specify the Part of Body Injured and indicate under whose supervision the accident occurred.
  6. State whether the accident was witnessed and, if so, provide the name of the witness.
  7. Detail the activity during which the injury happened, selecting either Interscholastic UIL Activity or Non Interscholastic UIL Activity. Specify the Sport/Activity if applicable.
  8. Provide a detailed explanation of how and where the injury occurred in the space provided.
  9. Have the school official sign and date the form at the bottom of Section 1.
  1. Next, move to Section 2, which must be completed by the parent or guardian.
  2. Fill in the Name of Student and Date of Birth, along with the Home Phone No.
  3. Indicate if the student is covered by any insurance plan and, if yes, provide the Policy No.
  4. Enter the Name of Parent/Guardian, their Relationship to Student, and their Address.
  5. Provide the Father's Name, Father's Employer, and the Name of Father's Insurance Company. If there is no insurance, write "None".
  6. Repeat the process for the Mother's Name, Mother's Employer, and Name of Mother's Insurance Company, writing "None" if applicable.
  7. Sign and date the authorization statement at the bottom of Section 2.

Once both sections are completed, submit the claim form to the address provided. Keep a copy for your records and ensure that all necessary bills are attached. Follow up with your primary insurance to ensure proper processing of the claim.

Your Questions, Answered

What is the Texas CLM 2 form?

The Texas CLM 2 form, also known as the Student Accident Claim Form, is a document used to report and claim benefits for injuries sustained by students during school-related activities. It is primarily designed for parents or guardians to provide necessary information about the incident, the injured student, and any applicable insurance coverage. This form must be submitted to Fidelity Security Life Insurance Company to initiate the claims process.

Who is responsible for completing the form?

The form consists of two sections. Section 1 must be completed by a school official for school-related accidents. However, if 24-hour coverage has been purchased and the injury is not school-related, a parent or guardian can complete this section. Section 2 is specifically for the parent or guardian to fill out, providing details about the student and their insurance coverage.

How do I submit the Texas CLM 2 form?

To submit the claim form, follow these steps:

  1. Complete both sections of the form as required.
  2. Send the form to the Claims Office at Fidelity Security Life Insurance Company, either by mail to P.O. Box 304, Duncan, OK 73534-0304, or electronically to [email protected].
  3. Ensure that the claim form is submitted within 90 days from the date of the injury.
  4. Keep a copy of the claim form for your records and provide a copy to the medical provider.

It is important not to rely on the medical provider to submit the claim form on your behalf.

What information is needed to complete the form?

To complete the Texas CLM 2 form, you will need to provide various details, including:

  • The name of the school district and school
  • The name and grade of the injured student
  • The date and time of the injury
  • A description of the injury and the circumstances surrounding it
  • Insurance information for both parents, if applicable

Accurate and thorough information will help expedite the claims process.

What if the student has other insurance coverage?

If the student is covered by another insurance plan, it is essential to file a claim with that primary insurance first. After receiving payment or an Explanation of Benefits (EOB) from the primary insurance, you can then submit the Texas CLM 2 form along with copies of the itemized bills and EOBs to Fidelity Security Life Insurance Company. This ensures that any remaining eligible expenses can be processed under the school’s supplemental policy.

What happens if I submit a fraudulent claim?

Submitting a fraudulent claim is a serious offense. If a person knowingly presents false information or a fraudulent claim, they may face legal consequences, including fines and potential imprisonment. It is crucial to provide truthful and accurate information when completing the Texas CLM 2 form to avoid any legal issues.

Common mistakes

  1. Incomplete Information: Failing to fill out all required fields can delay the processing of your claim. Make sure every section is complete.

  2. Incorrect Signature: The form must be signed by the appropriate person. Ensure that the parent or guardian signs in Section 2.

  3. Missing Documentation: Not including necessary documents, such as itemized bills or Explanation of Benefits (EOB), can result in a denial of your claim.

  4. Wrong Submission Method: Submitting the claim form to the wrong address or via the wrong method can cause delays. Always double-check the submission instructions.

  5. Failure to Meet Deadlines: Claims must be submitted within 90 days of the injury. Missing this deadline can result in a denial.

  6. Not Following Up: After submitting the claim, it is important to follow up. Not doing so may lead to unresolved issues.

  7. Inaccurate Insurance Information: Providing incorrect details about existing insurance coverage can complicate the claim process.

  8. Assuming Providers Will Submit Claims: Do not rely on medical providers to submit the claim for you. Always submit your own claim form.

Documents used along the form

When filing a claim using the Texas Clm 2 form, there are several other forms and documents that may also be required to support the claim process. Understanding these documents can streamline your experience and ensure that you have all necessary information at hand.

  • Itemized Medical Bills: These are detailed invoices from healthcare providers that outline the services rendered, associated costs, and any payments made. They are crucial for substantiating the medical expenses related to the injury.
  • Explanation of Benefits (EOB): This document is issued by your primary insurance company and explains what costs were covered, what was not, and the reasons for any denials. It helps clarify the financial responsibilities of the claimant.
  • Authorization for Release of Information: This form allows healthcare providers to share medical records and other relevant information with the insurance company. It ensures compliance with privacy laws while facilitating the claims process.
  • Accident Report: Often generated by the school or relevant authorities, this report details the circumstances surrounding the injury. It serves as an official account of the incident and can be important for validating the claim.
  • Proof of Enrollment: This document confirms that the injured student is currently enrolled in the school. It may be required to demonstrate eligibility for coverage under the insurance policy.
  • Claim Cover Letter: A cover letter accompanying the claim form can provide context and clarify any specific details regarding the injury and treatment. It serves to summarize the claim and highlight key points.
  • School District Policy Documents: These documents outline the insurance coverage provided by the school district, including any limitations or exclusions. They help clarify what the insurance covers and the responsibilities of the parties involved.
  • Witness Statements: If the accident was witnessed, statements from those individuals can provide additional context and support the claim. These should include details about what they observed during the incident.
  • Medical Records: Comprehensive medical records from healthcare providers detailing the diagnosis, treatment, and prognosis of the injury may be required. These records provide a complete picture of the medical care received.
  • Insurance Policy Documents: Copies of the insurance policy covering the injured student can help clarify coverage limits and benefits available under the policy, ensuring that all parties understand the terms of the coverage.

Gathering these forms and documents can enhance the efficiency of the claims process and improve the likelihood of a successful outcome. Always ensure that you submit all required documentation in a timely manner to avoid delays in processing your claim.

Similar forms

The Texas Claim 2 form is similar to the Student Health Insurance Claim Form. Both documents require detailed information about the injured student and the circumstances surrounding the injury. They serve to initiate the claims process for medical expenses incurred due to accidents. The Student Health Insurance Claim Form focuses on medical coverage provided by health insurance, while the Texas Claim 2 form specifically addresses coverage related to school-related incidents. Both forms emphasize the importance of accurate and truthful information to avoid complications in the claims process.

Another comparable document is the Accident Claim Form used in personal injury cases. This form also collects information about the injury, the injured party, and the circumstances leading to the incident. While the Texas Claim 2 form is tailored for students injured during school activities, the Accident Claim Form can be used in various contexts, including workplace or recreational injuries. Both documents aim to gather necessary details to support a claim for compensation, ensuring that the injured party receives appropriate medical coverage.

The Medical Expense Claim Form is another document that shares similarities with the Texas Claim 2 form. This form is utilized to claim reimbursement for medical expenses incurred due to an injury. Like the Texas Claim 2, it requires information about the patient and the nature of the injury. However, the Medical Expense Claim Form is often used for broader medical claims, while the Texas Claim 2 form is specifically designed for incidents occurring in a school setting. Both forms require itemized bills and supporting documentation to process claims effectively.

The Insurance Claim Form for Minor Injuries is also akin to the Texas Claim 2 form. This document is designed for situations involving less severe injuries where immediate medical attention may not be necessary. While the Texas Claim 2 form addresses injuries that may require extensive medical treatment, both forms facilitate the claims process for medical expenses related to injuries. They require similar information, including the injured party's details and the nature of the incident, to ensure that claims are processed in a timely manner.

Lastly, the School Accident Report Form has a close relationship with the Texas Claim 2 form. This document is typically completed by school officials to document the details of an accident involving a student. While the School Accident Report Form focuses on the incident itself, the Texas Claim 2 form is used to claim insurance benefits for medical expenses resulting from that incident. Both forms are essential for maintaining accurate records and ensuring that students receive the necessary support following an accident.

Dos and Don'ts

When filling out the Texas Clm 2 form, it's important to follow specific guidelines to ensure your claim is processed smoothly. Here are five things you should and shouldn't do:

  • Do complete all required sections. Make sure both Section 1 and Section 2 are filled out completely to avoid delays.
  • Do submit the claim form within 90 days. Timeliness is crucial. Ensure you send the form as soon as possible after the injury.
  • Do keep a copy of the claim form. Retain a copy for your records and provide it to the medical provider if necessary.
  • Don't rely on the medical provider to submit the claim. It is your responsibility to ensure the claim form is sent to the insurance company.
  • Don't forget to file with your primary insurance first. Always submit claims to your primary insurance before sending to the supplemental policy.

Misconceptions

Understanding the Texas Clm 2 form is crucial for parents and guardians navigating student accident claims. However, several misconceptions can lead to confusion. Here are five common misunderstandings:

  • The school is responsible for all medical expenses. Many parents believe that the school will cover all medical costs related to an injury. In reality, the school may only have a supplemental accident policy, meaning parents should have their own insurance to cover initial expenses.
  • Only school officials can complete the form. While Section 1 is typically filled out by a school official for school-related accidents, parents can complete it if 24-hour coverage was purchased and the injury occurred outside of school activities.
  • Claims must be submitted immediately after the injury. Some parents think they need to file a claim right away. However, the claim form must be submitted within 90 days from the date of injury, allowing some time for completion and gathering necessary documents.
  • The claim form is the only document needed. It’s a common belief that submitting the claim form alone suffices. In fact, parents must also submit itemized bills and any Explanation of Benefits (EOB) from their primary insurance to ensure proper processing of the claim.
  • All medical bills will be covered by the insurance policy. Many assume that the Texas Kids First policy will cover all medical expenses. This policy is limited and may not cover all costs, leaving parents responsible for any unpaid charges.

By addressing these misconceptions, parents can better navigate the claims process and ensure they are adequately prepared for any potential expenses related to their child's injury.

Key takeaways

Filling out and using the Texas CLM 2 form requires careful attention to detail. Here are key takeaways to ensure a smooth process:

  • Section 1 must be completed by a school official for school-related accidents, or by a parent if 24-hour coverage was purchased and the accident is not school-related.
  • Section 2 is designated for the parent or guardian to provide personal information about the injured student and insurance coverage.
  • Submit the claim form within 90 days from the date of the injury, regardless of other insurance coverage.
  • Keep a copy of the claim form for your records. Present a copy to the medical provider or facility.
  • Itemized bills must accompany the claim form. These are original bills, not monthly statements, and should include procedure and diagnosis codes.
  • File a claim with your primary insurance first. The school’s policy acts as a supplement to other valid coverage.
  • After receiving payment or an Explanation of Benefits (EOB) from your primary insurance, submit a copy of the claim form along with itemized bills and EOBs.
  • The Texas Kids First Provider Network offers access to medical professionals who may treat injured students without balance billing.
  • Be aware that presenting a false or fraudulent claim is a crime and can lead to severe penalties, including fines and imprisonment.

By following these guidelines, parents and guardians can effectively navigate the claims process for student accidents in Texas.