Tel: 408-222-1110

CLAIMS FORM

INF Claims Form

Filing claims when using your insurance is needed to make sure that you are reimbursed for any eligible medical expense paid out-of-pocket. Although INF allows direct billing, it is highly advised for plan members to submit a claim form anytime they use their insurance, regardless of whether you have paid out-of-pocket. Sending in the proper paperwork and documentation may help expedite the claims and reimbursement process. Below you can find information on how to file claims for International Visitors Accident and Sickness Insurance plans:

Submit Your Online
Claim Form

Submit Your Online
Claim Form

Log in to your MyINF Portal & file an online claim form. Navigate to the 'Active Plans' section of the Portal, and click the 'File a Claim' option.

Submit The Following
Required Documents

Submit The Following
Required Documents

  • Completed Claim Form
  • Copy of all Medical Bills (form 1500 or equivalent) & Itemized Receipts

Claims Payment

Claims Payment

After submitting your claims, the insurance company will reimburse you for your eligible medical expenses in accordance with the terms, conditions and limitations of your plan, depending on if all the documents are submitted correctly.

Claims Office Information:

Mail: Administrative Concepts, Inc. (ACI)

PO Box 4000; Collegeville, PA 19426

Toll Free: 855-428-3425 (from inside the U.S.)

Fax: 610-293-9299

Check Claim Status: 855-428-3425

Submit Bills Online: aciclaims@acitpa.com

Web: http://www.acitpa.com​

EDI Payor#: 22384

Download Claims Form
Policy Numbers Starting with GLM

Download Claims Form
Policy Numbers Starting with INF

Claims Office Information:

BMI Travel Assist

24/7 WhatsApp Assistance Number: +506-7061-2439

Email: asistencia@bmitravelassist.com

Additional Claims Information

All claims must be filed by completing the claim form found above in the Plan Member portal except BMI Travel Assist. This form should be completed by the Insured.

This form must be completed ONCE PER SICKNESS OR INJURY. The INF Claims Form for Providers should be completed by the Insured & Providers (Doctors office, Hospitals etc.).

The Insured should complete Section A. Providers should complete Section B of the form. The form can be mailed to the Insurance by the Provider's office or the Insured. Providers can also submit claims online using EDI Pay#: 22384.

Claims Process FAQs

Simply fill out the claim form & follow the instructions, as well as providing the additional required documentation. Make sure to complete this paperwork carefully to ensure prompt payment for eligible expenses incurred.

To check claims status:

1) Visit this website: https://secure.visit-aci.com/ClaimStatus/Account/Register

2) Register an account. If you have INF Elite or Traveler USA use this as the Policy Number: CC003939 or CC006470 . If you have Premier or Standard, use this as the Policy Number: CC003938 or CC006469

3) Use this portal to manage claims and check claim status

Additionally - please call 855-428-3425 ext 2 between 8:00 AM and 8:00 PM EST Mon - Fri to contact the claim office for any further questions.

Yes, eligible claims incurred while coverage is in effect will be paid. On the claims form, you need to designate where to send the check from the insurance company.