Insurance Claims

Claim Intake Form

Use the form below to submit your claim. Once we have received this information, we’ll reach out and give you an update on our next steps.
Claims Intake
Claim Type *

NOTE: Forms submitted on this website are reviewed during regular business hours. Although we try to respond as quickly as possible, we ask that you please allow up to 2 business days for a response.

Submission of this form is not a guarantee of payment or settlement for any claims.

Submission of this form is not considered a formal claim to your insurance carrier. We will review the contents of the data you submit and discuss (with you) how best to proceed with your claim.

Any information submitted through this form or the Aegis website is used for our own internal purposes and is never sold or given to anyone outside of our organization.

Need Help?

Call us M-F 8am to 5pm at 316-779-2920 and one of our team members would be happy to assist you!