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Important Information and Corporate Links

It's simple to apply:
Download, print, and complete the appropriate application. Then fax it to our offices at 317.262.2140.

File formats include Adobe Acrobat (PDF), HTML (for your web browser), and Microsoft Word (DOC). To view PDF files you will need Adobe Acrobat Reader.

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Claim Forms

Claimant's Statement (Standard Form) PDF
Non US Claim Form PDF
Dental Claim Form PDF
Accident Questionnaire PDF
Spanish Claimant's Statement (Standard Form) PDF
Spanish Non US Claim Form PDF
Spanish Dental Claim Form PDF
Spanish Accident Questionnaire PDF

Provider Direct Pay Agreement

Direct Payment Agreement PDF

Atlas Travel Insurance

Brochure, Rates, and Application PDF
Brochure only HTML26 KB
Spanish Brochure, Rates, and Application PDF
Spanish Brochure only HTML0 KB

Atlas Group

Brochure and Application PDF
Spanish Brochure and Application PDF

Atlas Professional (Multiple Trip Coverage)

Brochure and Application PDF
Spanish Brochure and Application PDF

Atlas Corporate Travel

Brochure and Application PDF
Spanish Brochure and Application PDF

GroupSecure^SM

Privacy Policy

IC+ Term Life

Brochure PDF
Application PDF

StudentSecure^SM

Brochure and Application PDF
Spanish Brochure and Application PDF

CitizenSecure^SM, Major Medical Insurance

CitizenSecure^SM Economy

HCC Life STM

Please Select a State to access the Brochure, Application, and Rate documents.