| Informacion para Reclamos
 
        
        
	
            
                Available Claim FormsTo submit a claim use one of the appropriate company links below. If none are available for your particular claim, please contact us directly.
		
                
                    
                        
                                
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 Allianz Life Insurance Company of North America 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 American Collectors Insurance 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 American Medical Security 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 American Modern Payment Link 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 Austin Mutual Insurance Company 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 Badger Mutual Insurance Company 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 Capitol Insurance Company 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 Capitol Insurance Company 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 Constitution Life Insurance Company 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 Dairyland Insurance Company 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 Germantown Mutual Insurance Company 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 Group Health Cooperative (GHC) 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 Hartford Insurance Company 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 Illinois Mutual Disability Insurance 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 Jackson National Life Insurance Company 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 Jefferson Pilot Financial 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 Mass Mutual Financial Group 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 Old Republic Surety Company 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 Principal Financial Group 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 Protective Life Insurance Co. 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 United Property and Casualty Insurance Company 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 Utica First Insurance Company 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 Utica National Insurance Group 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 West Coast Life Insurance Co. 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 Western National Insurance Group 
                                                
                                             
                                    
                                        
                                    
                                    
                                        
                                            
                                            
                                                 Workers Compensation Fund 
                                                
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