It is your contractual responsibility to report any claim, loss or lawsuit, or any incident or event which could reasonably lead to a claim, loss or lawsuit, directly to us as set forth in the policy. If for any reason you are unable to use our Online Claims App for this purpose, it is still your responsibility to report any such claim, loss, lawsuit, incident, or event to us as set forth in the policy by another method such as by telephone at 1-800-257-5590 or by facsimile at 1-877-452-6909. Your failure to do so may jeopardize any coverage as set forth in the policy.
Home / Submit Claim
Online Incident Reporting Form
Please complete the form below. Fields marked with an asterisk are required (*).
*All claims are managed by Claims Direct Access (CDA), a Prime affiliated company.
IMPORTANT NOTICE!
It is your contractual responsibility to report any claim, loss or lawsuit, or any incident or event which could reasonably lead to a claim, loss or lawsuit, directly to us as set forth in the policy. If for any reason you are unable to use our Online Claims App for this purpose, it is still your responsibility to report any such claim, loss, lawsuit, incident, or event to us as set forth in the policy by another method such as by telephone at 1-800-257-5590 or by facsimile at 1-877-452-6909. Your failure to do so may jeopardize any coverage as set forth in the policy.