If You Received Your Coverage Through Work…
Accident Coverage Customer Support
800-894-4532
Mon. – Fri. – 8 am – 5 pm ET
groupclaims@renaissancefamily.com
Useful Links
Group Accident Claims
Accident Forms
The following is a list of forms and documentation typically needed to file a claim for benefits under a group accident policy.
- Group Accident Claim Form [GAC-101C]: This form is required and must be completed by the employee. If the employee is unable to complete the form, a representative may complete the form on their behalf. The completed form and any additional documentation noted as required must be submitted within 30 days of the date of accident/injury.
- Group Accident Employer Statement for Claims [GAC-102C]: This form is required and must be completed by your employer.
