About SHIP Rehabilitation Claims Info Forms Common Questions Contact Us Helpful Info Ongoing Claims Continued Proof of Loss is required for benefits to be issued. Please contact our customer service department to assist in determining the proper requirements. PA DEPT OF INSURANCE LEGAL PRIVACY POLICY SITE MAP ©2021

About SHIP Rehabilitation Claims Info Forms Common Questions Contact Us Helpful Info Submitting Claims Filing a Claim If you are filing a new claim we will need a completed Claim Form, a completed Authorization for Use of Health-Related Information Form and any other documents contained in the Claim Information Packet that apply to your situation. From you: Claim Form, completed in full, signed and dated by you or your representative. If your representative completes and signs the form, please attach a copy of the appointment. Invoices or billing statements submitted by either you, your caregiver, or your facility. No benefits can be paid until a valid proof of loss (invoice or billing statement) is received by us. From your healthcare practitioner (doctor): Any necessary medical information will be requested by us from your licensed healthcare practitioner. From a facility, if you are claiming facility benefits (nursing home, assisted living): Any necessary facility information will be requested by us from your facility. Please note: Each long-term care policy varies in coverage and benefits and policies by state. Be sure that you clearly understand what the benefit triggers are under your policy and the facility/provider requirements. Please contact our customer service department if you have any questions concerning your policy. PA DEPT OF INSURANCE LEGAL PRIVACY POLICY SITE MAP ©2021

About SHIP Rehabilitation Claims Info Forms Common Questions Contact Us Helpful Info Site Map Home About SHIP Rehabilitation About Rehabilitation Court Documents Related Proceedings Master Service List Formal Comments Other Information Claims Info Submitting Claims First Time Claims Ongoing Claims Denied Claims California Claims Forms Common Questions Report Fraudulent Activity Contact Us Helpful Info Newsletter COVID-19 Bulletins PA Dept of Insurance Legal Privacy Policy Site Map PA DEPT OF INSURANCE LEGAL PRIVACY POLICY SITE MAP ©2021

About SHIP Rehabilitation Claims Info Forms Common Questions Contact Us Helpful Info Denied Claims If you believe that your claim has been wrongfully denied or rejected, you are entitled to a review of that determination conducted by long-term care professionals not involved in your original benefit eligibility determination. We will be glad to consider any new or additional facts regarding your benefit eligibility determination. Please refer to your original benefit eligibility determination letter for specific instructions. All communication should be made in writing to our customer service department. PA DEPT OF INSURANCE LEGAL PRIVACY POLICY SITE MAP ©2021