Claim Report

Claim reporting services are available 24 hours a day, 7 days a week, for your convenience.

There are several ways you may report a claim:

• You may call toll free at 1-866-794-5463 or complete and submit the form below;
• Complete a claim fax cover sheet and fax it toll free to 1-877-FAX-2-SWG (1-877-329-2794); or
• Complete and submit the form below.

Insured's Name *

Insured Contact Number *

Policy No. *

Brokerage Name *

Broker Contact Name *

Broker Contact Number *

Description and Comments for Claim *

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