We provide several methods of claims reporting:
For your convenience, you can download, print, and complete the FDFS First Report of Injury form, then submit either via fax or scan/email to the contact listings below.
For your convenience, you can download or fill out the appropriate Acord claim reporting form online, then fax or scan/email it to the contact listings below.
Please note, when you call us to report your claim, the questions listed on the form will be asked by our representative.
Submission of the form electronically will generally speed up the process and expedite the initial handling of your claim.
Help us help you by reporting your claim immediately.
Pursuant to S. 817.234, Florida Statutes, any person who, with the intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree, punishable as provided in S. 775.082, S. 775.083, or S. 775.084, Florida Statutes.