Accident & Health Claims
 

Spanish Claim Forms

• A&H Accidental Death Form_Spanish
• CB Accident Hospital Cash_Spanish PR
• CB Accidental Death Claim Form_ES(PR)
• CB Hospital Cash Physician's Statement_Spanish PR
• CB Physician's Statement-Accidental Injury_ES(PR)
• A&H Spanish Accident Medical Claim Form
• CB Accident Injury Claim Form_ES(PR)

Follow the instructions and mail to:

Chubb Group of Insurance Companies Claims Service Center
600 Independence Parkway
P.O. Box 4700
Chesapeake, VA  23327-4700
Phone: (800) 252-4670
Fax:  (800) 300-2538