REPORT A CLAIM

Claims Reporting

We provide several methods of claims reporting:

Workers’ Compensation Claims

Complete the FDFS First Report of Injury form, then submit either via fax or scan/email to the contact listings.

Commercial Auto, Garage, Public Transportation & General Liability Claims

Fill out the appropriate Acord claim reporting form then fax or scan/email it to the contact listings below.

Please note, when you call us to report your claim, the questions listed on the form will be asked by our representative.

Submission of the form electronically will generally speed up the process and expedite the initial handling of your claim.

Help us help you by reporting your claim immediately.

Forms

• Commercial Auto/Garage/Public Transportation – Acord 2 (2016/10)
• General Liability – Acord 1 (2016/10)
• Workers’ Compensation – Form DFS-F2-DWC-1 (10/2016)