We must receive proof of claim for an incident within sixty (60) days of the last day of your certificate period (or for claims incurred during a benefit period, sixty (60) days from the date the claim is incurred). A proof of claim must include all of the following:

1. A completed and signed Claimant’s Statement and Authorization form, together with any/all required attachments;
2. Itemized bills from physicians, hospitals, and other medical providers; and
3. Receipts for any expenses which have already been paid by you or on your behalf.