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Claim Information


Available Claim Forms

To submit a claim use one of the appropriate links below. If none are available for your particular claim, please contact us directly.

Our Companies


Aetna Allied Insurance American Modern Insurance Group
Assurant Health Benefit Planning Consultants, Inc. Blue Cross / Blue Shield
CNA Surety Coresource Dearborn National
Delta Dental Employers Insurance Group Erie Insurance
Foremost Insurance Group General Casualty Golden Rule Insurance
Guardian Life Hanover Hartford Insurance Company
HCH Administration HealthLink Health Alliance
Humana Indiana Insurance Mercury Insurance
MetLife Midwest Family Mutual Insurance Company National Flood Services
NCCI Holdings, Inc. North Pointe Personal Care
Philadelphia Insurance Companies Principal Financial Group Private Health Care Systems
Progressive Safeco Travelers
United Health Care Unitrin Westfield Insurance
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