ISBA Insurance Program - Claim Supplement

If you or your firm have previously reported any claims please provide the most current valued loss values. This information can be obtained by contacting your current broker/agent and requesting a complete loss run history.

If you have any unreported claims, or are aware of circumstances that could potentially develop into a claim, you should notify your current carrier before your policy expires.

To complete the Word document electronically
and email click here.

To print the PDF file, complete the printed form
and fax/mail click here.


		CLAIM SUPPLEMENT
		If you or your firm have previously reported any claims please provide the most current valued loss values. This information can be obtained by contacting your current broker/agent and requesting a complete loss run history. If you have any unreported claims, or are aware of circumstances that could potentially develop into a claim, you should notify your current carrier before your policy expires. To complete the Word document electronically and email click here. To print the PDF file, complete the printed form and fax/mail click here. To download a free copy of Adobe Reader, click the link below

		Insurance Program Administered by Lockton Risk Services