Skip to main content

Forms & Documents

Filing a Claim

Plan purchased after September 1, 2016

You can easily file a claim with Co-ordinated Benefits Plans, LLC by mail, fax, or email. To obtain a claim form, see below to download the appropriate claim form:

Claim Form Information and Instructions

Baggage Loss and Delay Form

Trip Interruption Form

Accidental Death and Dismemberment Form

Trip Cancellation Form

Accident and Sickness Form

Trip Delay Form

Information you'll need

You should have the following information available to file a claim:

  • Program Reference Number (listed on the back of the iNext Travel Card) for Comprehensive and Comprehensive Plus plans.
  • What coverage type or benefit category the claim is under (e.g. Medical Expense, Baggage Loss, etc.)
  • The date the covered treatment or loss occurred
  • The amount that was paid (if applicable)

Sending the form

You should complete the claim form for accuracy, sign the form, and return it to Co-ordinated Benefits Plans, LLC along with any requested supporting documentation, such as original receipts, diagnosis, proof of travel (e.g., a copy of a flight itinerary), and primary insurance information. We recommend filing via email at Team1@cbpinsure.com.

It is important to remember to keep your receipts from doctor’s visits, pharmacy prescriptions and diagnostic records. These will be required by Co-ordinated Benefits Plans, LLC when you file a claim. All diagnostic forms should be translated into English if possible. One reason claims processing can be prolonged is due to lack of documentation. The better prepared you are, the faster the claims processing can occur.

Completed claims forms must be completed and sent with the original itemized bills to the claim administrator within 90 days. Submit claims or inquires to:

Co-ordinated Benefits Plans, LLC
P.O. Box 26222
Tampa, FL 33623
Email: Team1@cbpinsure.com

If you have any questions about your claim, please feel free to contact Co-ordinated Benefits Plans at:

Phone: 1-866-723-3063 or 727-412-7378
(It is strongly recommended that claims be filed via email)