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File a Hospital GAP PLAN® Insurance Claim

AF Limited Benefit Hospital GAP PLAN® Insurance is a supplemental, limited benefit medical expense policy that is designed to help pay the deductible and co-insurance when you or a family member receive inpatient care.

The fastest way to file a gap insurance claim is through your online account or our mobile app, AFmobile®. Download AFmobile from the App Store® or Google Play™.

File a Claim


Required Documentation

When filing a gap insurance claim you will need to provide the following documentation:

  • Statement of Insured, completed via online claim filing or paper claim form
  • Itemized Bills with diagnosis from each of your providers with a complete breakdown of charges for each date of service
  • Explanation of Benefits (EOB) from your primary medical insurance carrier

We may also need:

TIP: When completing a paper claim form, please submit a separate form for each unique diagnosis.


File Your Claims on AFmobile®

Manage your gap insurance claims using our mobile app, AFmobile!

  • Submit claims
  • View claim status updates 
  • Upload additional documentation

Download on the App Store

Get it on Google Play

Need help?

If you have questions about your policy, log in to your online account or AFmobile to download your policy or visit the gap insurance support page.

To file a paper claim, download and print a claim form here.
NOTE: Paper claim filing is not the fastest option. File a claim online or through AFmobile to get your money faster.

American Fidelity Assurance Company