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In Case of Emergency
If an injury or illness occurs while on the field:
Seek medical attention as needed. Contact AGWM Insurance Specialist and file a claim with all itemized statements and receipts for medical expenses with GTL. Expenses incurred for injury or ilness will be reimbursed according to GTL policy once claims are filed and deductible is met. Claims must be filed within 90 days of onset of sickness or injury.
If Trauma or Medical Emergency Evacuation is needed:
STEP 1: Call MEDEX 24-Hour Emergency Response Center at 1-410-453-6330 (collect call). MEDEX will need your group number which is 9041.
STEP 2: MEDEX will give you directions or arrange transport if needed to the nearest medical facility. They will also contact relatives in the U.S. for you. If needed, MEDEX will contact banks, credit card companies, etc. to help you arrange for payment. For emergency medical evacuation, MEDEX will need to consult with the attending on-site physicians. All evacuation services must be arranged through MEDEX. GTL does not pay travel expenses.
STEP 3: Contact AGWM Insurance Specialist and file a claim with all itemized statements and receipts for medical expenses with GTL. Expenses incurred for injury or illness will be reimbursed according to GTL policy once claims are filed and deductible is net. Claims must be filed within 90 days of onset of sickness or injury.
*Please see complete policy, being mindful of benefits available and general exclusions.
Other contact information:
AGWM Insurance Specialist
Amanda Rickman
1445 N. Boonville Ave.
Springfield, MO 65802
Ph: 417-862-2781 ext. 3126, E-mail: arickman@ag.org, Fax: 417-862-5977 DISSINGER INSURANCE (for questions on GTL/MEDEX policy or claims)
Max Biggerstaff: 1-913-491-6385, Fax: 1-913-491-0527, www.dissingerreed.com
CLAIMS
Policy number: 24N-018-001 P
Guarantee Trust Life
PO Box 1148
Glenview, IL 60025
Phone: 1-800-622-1993, Fax: Attn: Lori Farabow 1-847-904-5922
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