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All Other Claims

For all non-Workers’ Compensation related, use the contact information listed below.

I Have Another Type of Claim
Online Form

I Have Another Type of Claim

Remember to protect your property to prevent any further damage and contact us any of the following ways:

REPORT BY PHONE: (800) 825-9489
Please have your policy number and name of insured/policyholder as named on the policy.

Please have the following claimant information:
Full name, age, date of birth, social security number
Date/hours of employment and wages
Date, time and location of injury
Home address and phone number

REPORT BY E-MAIL: [email protected]

Email your completed State Workers’ Compensation First Report of Injury form.

Online Form

Fraud Statement – Applicable in All States:
Any person who knowingly and with intent to defraud any insurance company or other person, files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime and subjects the person to criminal and civil penalties.

Report a Claim

Insured Information

(*) Required field

First Name *

Insured's Name *

Last Name *

Address *

Email *

Enter Email

Confirm Email *

Confirm Email

City *

State *

Zip code *

Questions or Comments *

Contact Information

* denotes a required field

Contact Person *

I consent to Ameritrust Group Inc. subsidiaries and its affiliates collecting my details through this form.

Address *

City *

State *

Zip code *

Phone Number *

When to contact *

Email *

Policy Number *

Date of Loss *

Location of Loss *

Lawsuit Filed (Yes/No) *

Yes

Description of Loss/Accident *

Were Authorities Notified (Y/N) *

Yes

If Yes, Whom? *

Witness Information

Witness Name *

Primary Phone *

Secondary Phone

Address *

City *

State *

Zip code *

Add Witness Remove Witness

Claims can also be reported to the AmeriTrust Claims Call Center at (800) 825-9489, via fax at (855) 603-8409 or by e-mail at [email protected]. If there are any questions, or if additional assistance is required, please call (800) 825-9489.

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