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Re-Open Claim Request
$350.00

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If paying by Credit Card you need to select "Pay with Debit or Credit Card" after selecting "Click Here to Pay Now" above...

Your Case Manager will direct you with your Service Selection...

Initial Claim Request
$750.00

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If paying by Credit Card you need to select "Pay with Debit or Credit Card" after selecting "Click Here to Pay Now" above...

Other Services
$0.00

PayPal ButtonPayPal Button

If paying by Credit Card you need to select "Pay with Debit or Credit Card" after selecting "Click Here to Pay Now" above...

*Prices subject to change. There is a $15 service fee to process Paypal payments.

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