Claims - Personal
Claims - Personal
Contact Numbers
- Claims Reporting : 847.700.9100 Extension #1
- Claims Fax Number : 847.228.8571
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Submit Online Personal Auto Accident Report
- Report Fraud
- Driver Accident Report Form (IL & IN Only)
- Witness Accident Report Form (IL & IN Only)
- Passenger Accident Report Form (IL & IN Only)
- Notice of Loss ASI - Theft & Fire (IL & IN Only)
- Notice of Loss UCC - Theft & Fire (IL & IN Only)
- Medical Payment Form (IL & IN Only)
- HIPAA Form - ASI (IL & IN Only)
- HIPAA Form - UCC (IL & IN Only)
- Injury Form (IL & IN Only)
- KAI Body Shop List (IL & IN Only)
- KAI Drive-In Schedule (IL & IN Only)
- IN POA (IN Only)
- IN Odometer Disclosure Statment (IN Only)
- IL Letter of Guarantee (Lienholders) (IL Only)
- IN Letter of Guarantee (Lienholders) (IN Only)
© 2005 - 2010 American Service Insurance Company
All Rights Reserved
All Rights Reserved
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