Insurance Claim Forms

Please select the appropriate Claim Form for the type of loss you wish to report. Download and print out the documents. Then fill in all necessary information and fax to us at (812) 474-2184. These forms are provided in Adobe PDF format which requires the Acrobat Reader to be installed on your computer. Click here to download the latest version of Adobe Reader.

Please feel free to call us with any emergency claim questions at our 24/7 number, (812) 479-8651.

Auto Claim
Worker's Compensation Claim
Property/Liability Claim