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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.

Skip the Forms, Apply Online Now

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 Agreenment PDF

Atlas Travel Insurance

• Brochure, Rates, and Application PDF
• Brochure only HTML41 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

• Brochure PDF
• Enrollment Form PDF
• Request for Proposal PDF
• Spanish Brochure PDF
• Spanish Enrollment Form PDF
• Spanish Request for Proposal PDF

Privacy Policy

• Privacy Policy PDF

IC+ Term Life

• Brochure PDF
• Application PDF

StudentSecure^SM

• Brochure and Application PDF
• Spanish Brochure and Application PDF

CitizenSecure^SM, Major Medical Insurance

• Brochure PDF
• Spanish Brochure PDF
• Application and Rates PDF
• Spanish Application and Rates PDF

CitizenSecure^SM Economy

• Brochure PDF
• Spanish Brochure PDF
• Application and Rates PDF
• Spanish Application and Rates PDF

HCC Life STM