Archdiocese of NY Student Accident Insurance Program
Effective August 15, 2014, the Archdiocese of New York has a new Student Accident Insurance Program. All Archdiocesan K-8 Schools, high schools, parish Religious Education Programs, parish Catholic Youth Ministry Programs, parish intramural sports programs and CYO activities are included.
Click on the links below to for program information and forms required to report an accident and submit a claim:
This form is to be used to report accidents to Catholic Mutual that involve students, religious education children and children who participate in School or CYO sports programs. For CYO, as soon as possible after an accident occurs involving a CYO participant, the Coach or Parish Coordinator should fill out this form and follow parish policy to have the form faxed to Catholic Mutual Group. This is not a form for a parent to complete.
This form is to be used to file a claim with the insurance company for accidents that involve students, religious education children and children who participate in School or CYO sports programs. It is the School’s or Parish’s responsibility to complete Part 1 of the form. It is the parent/guardian’s responsibility to complete the remainder of the form, attach necessary EOB’s and itemized bills, and mail to the insurance company at the address listed.
Please contact your School or Parish Administration Office with questions.