Below you will find downloadable forms for the K-12 Voluntary Accident Insurance Plan offered by your school district

Helpful information about the policy

LOW OPTION = 65% of coverage up to $25,000

MEDIUM OPTION = 75% of coverage up to $50,000

HIGH OPTION = 100% of coverage up to $100,000 

The carrier for all voluntary policies is Gerber Life Insurance Company
The address is PO Box 2415 Grapevine, TX 76099-2415
The phone number to call for claim service or status is  (866) 975-9468
The fax number to submit claims and bills is  (469) 417-1969  you may also email


All claims MUST be reported within 90 days of injury!


Premiums listed on the applications and website are for the school year.

The premium is a one time fee for the school year and cannot be prorated.

If you have Medi-Cal, this coverage will not benefit your student/child.

If you have personal insurance, this policy will be secondary.

If you have a deductible with your personal insurance, this policy will help pay the percentage indicated on the purchased premium.

Football Coverage is ONLY for Football related accident.

24-hour coverage will cover the student/child anywhere in the US home or school.

School Time coverage is only for accidents that happen on campus and during a school-sponsored supervised activity.

The following links are ONLY for

Helix Charter High School

Grossmont School District

San Diego School District

Steele Canyon

Student Application for ALL other K-12 Schools click below!

Claim Form for all student policies below


  • Day/Overnight Camps
  • Youth & Sports Camps
  • Community and School Sponsored Clubs
  • Nursery/Day Care Centers
  • Catastrophic Coverages

Download and complete the application below for a free quote!

Please call our office at 1-310-826-5688 or EMAIL US HERE for further assistance.

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