Report A Claim

Telephonic
Reporting
is also available.

DIAL 1-877-327-5444 TO
REPORT YOUR CLAIM BY
PHONE AND RECEIVE YOUR
CLAIM NUMBER INSTANTLY.

 

START FORM

 

directions

To report a claim, click on the button above. The web form will take approximately 15-20 minutes – please make sure you have adequate time before starting the process as you will not be able to return to the form at a later time.

Before you begin, please have all essential details available (Claimant SSN, birthdate, hire date, etc.) and document attachments (Post-offer Medical Questionnaire, medical notes, witness statements, etc.). DO NOT CLICK THE BROWSER BACK BUTTON - you will have the opportunity to review and edit your entries before submitting the form.

If you have any questions, please contact us at info@synergyinsurance.net or 1-866-710-0908.

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