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If your insurance policy is written with one of the following companies please call that company directly at the number listed below:
 
Alpha Property & Casualty, Inc.
(877) 272-8719		   Guideone Insurance
(800) 688-3646
American States Business Insurance
(888) 557-5010		   Haggerty Classic Auto Insurance
(800) 747-5348
Atlanta Casualty Company
(800) 225-8930		   Illinois Mutual
(800) 437-7355
Austin Mutual Insurance Group
(888) 321-9392		   Jackson National Life
(800) 873-5654
C.N.A. Life Insurance
(800) 262-5238		   Mendota Insurance Company
(800) 422-0793
C.N.A. Personal Insurance
(800) 262-9262		   Old Republic Surety
(262) 797-2640
Celtic Life Insurance Company
(800) 766-2525		   Pafco General Insurance Company
(800) 342-5243 then press 5
Dallas Mutual
(515) 992-4121		   Pekin Insurance Companies
(800) 233-8487
Employers Mutual Insurance Company
(515) 280-2631		   Redland Insurance Company
(800) 742-6837
Farm and City
(515) 362-7600		   SAFECO Insurance
(888) 557-5010
Fortis Insurance Company
(800) 800-1212		   Windsor Group
(888) 951-5599
Grinnell Mutual
(877) 467-2252		   Zurich Insurance Group
(800) 378-9933
 
If you're not with one of the above listed companies, are unsure which company your policy is written with or have been unsuccessful in obtaining the information you require from the above listed numbers please complete and submit the following form. We'll process your change and send you a confirmation e-mail as soon as possible.
 
Name:
Address:
City:
State:
  Zip:   Phone:
E-mail:
Main Property Information
Loss Information
Date of Loss: Time of Loss:
Type of Loss: Line of Business:
Were police contacted? Yes  No Was anyone injured? Yes  No  Not Sure
Approximate total dollar amount of loss? 
Please describe the property involved with this claim, the property of others involved and any other information that might be useful to us:
Other Property Information (if applicable)
List any named insureds, witnesses, passengers and/or claimants (others directly affected by the loss) who had a role in this loss:
Property Information #1
Name:
Address:
City:
State:
ZIP:  Phone: 
Role in Claim:
Property Information #2
Name:
Address:
City:
State:
ZIP:  Phone: 
Role in Claim:
Property Information #3
Name:
Address:
City:
State:
ZIP:  Phone: 
Role in Claim:

  

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