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2018-19 Catastrophic Insurance Claim Forms



JULY 1, 2018 – JUNE 30, 2019

$10,000 Deductible

Agent of Record:               Dissinger Reed, LLC

                                                8700 Indian Creek Parkway, Suite 320

                                                Overland Park, KS  66210

                                                1-800-386-9183 or 1-913-491-6385



Carrier:                                  National Union Fire Insurance Company

Underwriter:                       AIG

Name of Group:                 Mississippi High School Activities Association Inc.

Policy Number:                  SRG0009144128


Claims Mailing Address:


                                                Personal Accident Claims Department

  1. O. Box 25987

                                                Shawnee Mission, KS  66225

                                                1-800-551-0824 Phone

                                                1-866-893-8574 Fax            

2018-19 Catastrophic Insurance Claim form

Claim Form, 6.12.18

MissHS_BenefitsSummary 2018

Click the above links to download a fillable PDF claim form and the Benefit Summary documents.

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