Claim Forms
Instructions
In order to file a claim you will need to print the appropriate claim form related to the Company through which your policy was written. Once you have determined the correct company(s), you can click on the link below to print the appropriate claim form(s). Instructions for filing a claim will be on the form.
Contact agent directly for more information.
Forms
Click on one of the buttons below for that program's claim form or Claim Kit:
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Aegis Claim Form | |
AIG Claim Form |
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AIG Trust Claim Form | |
Berkley Claim Form |
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Capitol Claim Form | |
QBE Claim Form |
Please Note
- Please make sure you attach all unpaid medical bills from the primary insurance coverage and EOB�s showing adjustment of the claim by the primary insurance plan.
- If there is no primary plan in effect, this insurance would be considered primary.
- All medical bills should be attached for review and the form should be filled out completely.
- Failure to submit a completed claim form and documentation will result in delayed claims payment.
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Specializing in Sports Liability and Accident Insurance
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