Insurance Information

Accident Reporting & Completion of Report Forms

All incidents should be reported immediately to your Insurance Carrier or Claim Payer to assist in the expeditious handling of your claim. For your convenience, we have developed a number of Report Forms designed to collect the information necessary to allow for the speedy processing of the claim. These forms are available in PDF format.

Coverage for District 5010

Insurance Coverage for Rotary Youth Exchange is Underwritten by ACE American Insurance Company, 436 Walnut Street, Philadelphia, PA 19106.

You must notify ACI of a loss. This notice should identify you, the Policyholder, and the Policy Number: Accident and Sickness Benefits GLMN04849759 and Security Evacuation and Personal Liability GLMN1121504A.

Procedures for Filing a Claim

  1. Obtain the appropriate claim form for the specific type of claim to be filed.
  2. Complete all sections of the form relevant to your claim.
  3. Attach or enclose any supporting documentation. This includes all bills, repair cost, police reports, other insurance information, etc.
  4. Photocopy the claim form and back up documentation for your records. To assist in expediting a determination on your claim, we ask that you send a copy of the Claim form and your supporting documentation to the insurance carrier or claim payer.
  5. For customer service, eligibility verification, plan information, or to file a claim, contact: Administrative Concepts, Inc. (ACI) at 1-888-293-9229 (from inside the U.S.) or 610-293-9229 (from outside the U.S.); fax 610-293-9299 for claims or inquiries or e-mail go to

Mail claims to: Administrative Concepts, Inc.
994 Old Eagle School Rd., S. 1005
Wayne, PA 19087-1706

For other assistance services call: AXA Assistance at 855-327-1414 (Toll-Free) or 630-694-9764 (Direct Dial) or e-mail

To access ACE’s Travel Assistance Website go to and enter your username and password (shown on your Travel Assistance ID card).

Official Forms and Documents