To report a claim or potential claim to Coverys, follow the instructions below per the underwriting company that issued your policy.
If your policy was issued by ProSelect, ProMutual, Coverys RRG, or Coverys Specialty
Select a method of reporting —
1. Sign in to your policyholder account on the
Coverys Customer Portal and complete the form in the "Report an Event" section,
OR
2.
Download the PDF form below that corresponds to your state, complete it, and return it as outlined in the form.
- Notification of Claim or Potential Claim Form - CT, FL, GA, LA, MA, ME, NC, NH, NY, RI, SC, TN, TX & VT
- Notification of Claim or Potential Claim Form - DC, DE, MD, NJ, PA, VA & WV
- Notification of Claim or Potential Claim Form - IA, IL, IN, MI, MN, ND, NE, OH, SD & WI
- Notification of Claim or Potential Claim Form - AZ, CA, ID, NM, OR & WA
If your policy was issued by Coverys Custom Accounts
Download the PDF form below that corresponds to your state, complete it, and return it as outlined in the form.
- Notification of Claim or Potential Claim Form - CT, FL, GA, LA, MA, ME, NC, NH, NY, RI, SC, TN, TX & VT
- Notification of Claim or Potential Claim Form - DC, DE, MD, NJ, PA, VA & WV
- Notification of Claim or Potential Claim Form - IA, IL, IN, MI, MN, ND, NE, OH, SD & WI
- Notification of Claim or Potential Claim Form - AZ, CA, ID, NM, OR & WA
If your policy was issued by Preferred Professional Insurance Company (PPIC)
Download this PDF form, complete it, and return it as outlined in the form.