Submit a ClaimReport New Claims at: (516) 594-1500Or fill out the form below: Name * First Name Last Name Relationship to Reporting Party * Self Broker Attorney Email * Phone * (###) ### #### Date of Loss, Injury, or Incident * MM DD YYYY Claim Type * Select Type Business Owner's Policy Commercial Auto Commercial Property Commercial Umbrella EPLI General Liability Homeowners/Renters Personal Umbrella Professional Liability Workers' Compensation Insured Name (If Applicable) Policy Number (if known) Short Description of Loss, Injury, or Incident (Please note the injured person’s name, if applicable) * Thank you!
