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SRP 5063S Collegiate Ministries Group Activity Accident and Illness Policy

The American Income Life SRP 5063S is a group activity accident and illness policy to insure all participants in your sponsored events. This policy, offered by American Income Life Insurance Company, is designed to cover the typical accidents and illnesses which occur during group activities.

To request coverage complete the online activity report form. American Income Life has made this an interactive form for your convenience. If it is not already done for you, enter the policy number (5063s) in the appropriate field. Additionally, make sure to enter the correct rate for the activity, or activities, for which you are requesting coverage:

  • 40¢ for snow sports, athletics, and domestic mission trips
  • 24¢ for all other group events

The American Income Life 5063S is a blanket policy, so no names are required; just the total number of students and volunteers, and the date(s) for your activity.

Once you have completed the form, you will be provided with an immediate confirmation page summarizing your report. Print this page and mail it to the American Income Life Special Risk Division, along with your premium payment, after the event or activity is over.

American Income Life Special Risk Division
P.O. Box 50158
Indianapolis, IN 46250

In the event of an accident, a claim form should be submitted to American Income Life by a leader not related to the patient. Include copies of itemized medical bills and the explanation of benefits from personal insurance with the form, or mail them later as they become available. The American Income Life SRP 5063S policy pays eligible medical expenses after personal insurance. If an individual has no personal insurance, the American Income Life SRP 5063S policy will be primary. There is no deductible for this policy.

If you have any further questions regarding the American Income Life SRP 5063s policy coverage and service, please contact the American Income Life Special Risk Division. The toll free number is 800-849-4820, or e-mail