Letters

Members enrolled in a plan administered by American Group Administrators, Inc. may receive letters from us requesting additional information prior to us releasing a claim payment. Using the links below, you can view samples of the letters we may send to the members. You will need Adobe Reader to view these documents.

If your members have questions on any correspondence they receive from American Group Administrators, Inc., please do not hesistate to ask them to contact us. CLAIMS WILL NOT BE PAID UNTIL WE RECEIVE WRITTEN RESPONSE TO THESE LETTERS.

Coordination of Benefits Letter ― Advises on the availability of other insurance

Certificate of Creditable Coverage Letter ― requests documentation of prior insurance

Pre-Existing Condition Letter ― requests information on treatments received prior to your effective date under your AGA plan.

Accident/Injury Letter ― requests information on an accident or injury based on the claim received. Even if the claim was NOT a result of an accident or injury, we need your response. This letter is sent based on the services provided and diagnosis codes used on the claims submitted by providers.

Subrogation Letter ― requests information on third party liability if the condition you sought treatment for was the result of negligence of another individual or entity. If you reply that you are pursuing recovery from a Third Party, you will then receive the Subgrogation Form.

Full Time Student Letter ― requests information on the Full Time Student status of enrolled dependents over the age of 19.

Custody Letter ― request information on newborns, or new dependents added to your coverage.