Claim/Incident Report

Please provide contact information of your company, and a short description of the incident, we will contact you shortly for more details. If you prefer the written form, please Click Here.

It is urgent that you contact Select immediately to confirm receipt and gather all relevant documentation as it will be needed in the review and adjustment of the claim.
Please be advised late notice to the insurance carrier may result in a declination of coverage.

Thank you for submission!

Please call us at 888-542-9002 to confirm your form has been received. If you do not receive an email acknowledgement within 24 hours, please email us at pm@selectagency.com