General Agent & Surplus Lines Broker

Report a Claim

In the event of loss or damage, please complete the appropriate ACORD Loss Notice with as much detail as possible:
  • Policy Number
  • Time, Date & Location of the Loss
  • Detailed Narrative of Loss
  • Name, Address & Phone Number of Parties Involved
    **If applicable, Contact Name & Phone Number of Law Enforcement or Fire DepartmentResponding to Loss
These are the most commonly used ACORD Loss Notices  

Property Loss Notice (ACORD 1)
Automobile Loss Notice (ACORD 2)
General Liability Notice of Occurrence (ACORD 3)
Fraud Statements (ACORD 63)


To report claims directly to the carrier, see the following company information:

American Reliable/American Bankers/Voyager Indemnity

Colony Specialty

Great Lakes Insurance SE

National Indemnity Co/Columbia Ins Co/National Fire & Marine/National Liability & Fire

Nautilus Ins Co/Great Divide Ins Co

Northfield Insurance Company

Scottsdale Ins Co/Scottsdale Indemnity Ins Co/National Casualty Co

Western World Ins Co/Tudor Ins Co

For all other companies, including Certain Underwriters at Lloyd’s, London, please send directly to Superior Underwriters/Primex Insurance Brokers/GSU Insurance Services and we will forward the loss notice to the appropriate claims personnel.

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800-782-8699 (WA Office) 866-366-1644 (UT Office)
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