Request for Group Accident Insurance Coverage

Request for Group Accident Insurance Coverage


This request must be received by Risk Management prior to the departure date for the insurance to be in effect. Please complete and submit the form; a confirmation number will be issued via email.


If you have any questions or concerns, please call 277-2753, or email Ammie Corbett (ammiecorbett@unm.edu) and Viktor Gough (vgough@unm.edu).