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Claims should be reported promptly by phone, fax or in writing to the Claims Department using an ACORD LOSS NOTICE. Provide all pertinent information including the date, approximate amount of loss, the origin of the loss, and where the insured can be contacted. OR COMPLETE AND SUBMIT THE FORM BELOW.

All loss assignments will be made by the FAIR Plan. Adjusters are not authorized to accept loss assignments for FAIR Plan losses from any other source. The FAIR Plan is not open on weekends nor does it have 24-hour service. Producers should instruct their Insureds to contact them immediately in an emergency situation or in the event of a serious loss. All such calls should then be reported to the FAIR Plan's claim department on the next working day.

You may hear a special message when calling the FAIR Plan on long holiday weekends. This message will tell you who to contact in emergencies.

CLAIMS REPORT FORM:
Please fill in the information and click "send".
Note:
** means required field

** Person reporting Loss:
** Phone Number:
** E-Mail Address:
** Date:
** Producer Name:
** Producer Phone:
** Insured's Name:
** Insured Home Phone:
** Insured Work Phone:
** Policy #:
** Property Address:
** Property City:
** Date & Time of Loss:

** Enter the Cause/Description of Loss
and other comments below.




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Connecticut FAIR Plan - 77 Hartland Street, Suite 308 - P.O. Box 280200 - East Hartford, CT 06128-0200
Telephone: (860) 528-9546 - Fax: (860) 282-0070
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