Forms
Claimant's Statement and Authorization Forms
HCCMIS’s Claimant's Statement is available online. Simply print, complete, attach original paid medical receipts and mail to HCCMIS.
International Claimant's Statements
Claimant’s Statements for International Products |
Downloads |
Format |
| Claimant's Statement (Standard Form) | English/Spanish | [PDF] |
| Non US Claim Form | English/Spanish | [PDF] |
| Dental Claim Form | English/Spanish | [PDF] |
| Accident Questionnaire | English/Spanish | [PDF] |
| CorpsCare | English | [HTML] |
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HCC Life Resource Center
Claimant's Statements for HCC Life STM
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| Please select a State to access the HCC Life Claimant's Statement for use with HCC Life STM policies. |
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International Travel Medical Insurance – HCC Medical
