The Liquidation Court has directed that notice be given to all persons who may have a claim against PAHPT. If you have such a claim and wish to be considered in the Liquidation proceedings, you must follow the procedure described below or you will be forever barred from asserting a claim.
The Liquidation Court has established June 20, 2017, as the “bar date” for the filing of claims against PAHPT. To have your claim considered in the PAHPT liquidation, a Proof of Claim form must be properly completed, mailed, and received no later than June 20, 2017.
1. CLAIMS FOR LOSS UNDER THE POLICY:
If your claim is for POLICY BENEFITS and if your claim is already filed with PAHPT, you need to complete the proof of claim form, but you do not need to resubmit documentation to support your claim. If additional information is required, you will be contacted. If this is a new claim, please attach documentation to support claim.
2. RETURN OF UNEARNED PREMIUM OR OTHER PREMIUM REFUNDS:
If your claim is for the Return of Unearned Premium or Other Premium refunds, please complete the front of this form. Please attach the appropriate documentation to support claim.
PHYSICIANS’ ALLIANCE HEALTH PLAN TRUST, IN LIQUIDATION
3635 Peachtree Industrial Boulevard, Suite 200
Duluth, GA 30096-2806