ONLINE CLAIM SUBMISSION

General Liability

To report your claim online, please complete all applicable fields.
When you have finished entering your data, please be sure to press the ‘Submit’ button to send your information.

After pressing the ‘Submit’ button, a copy of your claim will be emailed to you.

Please Note: Once your claim has been reviewed, we will contact you directly to obtain additional information.

Insured

Contact Information

Loss Information

YesNo

Remarks