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SeeChange Health Insurance Company
Conservation Manager: Joe Holloway
Email Address: HollowayJ@caclo.org
Telephone Number: (415) 676-2126
Conservation Date: 11/19/2014
Liquidation Date: 01/28/2015
POC Final Filing Date: 12/31/2015
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Please click on the following to obtain a Proof of Claim Form.

PROOF OF CLAIM INSTRUCTIONS

  1. The Proof of Claim must be typed or legibly printed in ink.

  2. The Proof of Claim must have all items completed and questions answered. If an item is not applicable, please write "N/A" in that section. Your Proof of Claim will be returned to you if any items are left blank. Please review the entire form for completion prior to mailing.

  3. If you need additional space to fully answer any question, please do so on a separate sheet of paper and attach it to your Proof of Claim.

  4. You must attach to the Proof of Claim documents or evidence supporting your claim. FAILURE TO PROVIDE SUFFICIENT DOCUMENTS OR EVIDENCE SUPPORTING YOUR CLAIM IS GROUNDS FOR REJECTION.

  5. You have an ongoing duty to supplement your Proof of Claim with supporting documentation as additional information is received. This requirement includes notice of any change of address.

  6. The Proof of Claim must be signed by the Claimant who is named in Part 1, or by a representative of the Claimant who has knowledge of the matters set forth in the Proof of Claim and in any accompanying statement and supporting documents.

  7. All Proofs of Claim must be postmarked no later than December 31, 2015. The Liquidator is not responsible for undelivered mail.

  8. The Liquidator suggests you keep a copy of the completed Proof of Claim for your records.

GENERAL INFORMATION

After all claims have been approved or rejected, the Liquidator will seek Court approval to begin making distributions to the approved claimants from the assets of the Company.

If you have any questions about the Proof of Claim procedure, you may call (415) 676-2123 or e-mail to: SeeChangePOC@caclo.org.