The insurance claim administrators, Personal Insurance Administrators (PIA), need authorization from Student Health and Counseling Services before claims are processed.

The underwriter, Nationwide Life Insurance Company, maintains the right to investigate submitted claims, and sometimes require additional information including claim forms as necessary for the proper adjudication of the claim, at its discretion.

It may be that you are lacking a referral from Student Health and Counseling Services or the service you had received is an insurance exclusion (see page 14 of your insurance brochure for details of exclusions and limitations).

It is also possible that the claim is a pre-existing condition (see page 15 of the insurance brochure for more information).

You have the right to request an independent medical review if healthcare services have been improperly denied, modified, or delayed based on medical necessity.

NOTE: Always keep a copy for your files of all forms submitted for claims.