Schultheis Insurance


Claim Forms

Please select the appropriate Claim Form for the type of loss you wish to report. These forms are provided in Adobe PDF format which requires the Acrobat Reader to be installed on your computer. Click here to download and install the Adobe Acrobat Reader.

Once you have completed the form, please fax it to our Claims Department at (812) 474-2184.



Commercial Auto Claim Worker's Compensation Claim Property/Liability Claim


Important Notes:

  • Claim Forms will open in a new window. Please close the window to return to this page.
  • To store a copy of these reports on your computer, hold down the Shift key and click each item
  • You must have the Adobe Acrobat Reader installed on your computer to view/print PDF files



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