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Online claim form for businesses

You may report a claim by calling your insurance agent, contacting Jewelers Mutual Insurance Company at (800) 558-6411, or sending the completed Claim Report e-mail form. We will make every effort to contact you about your claim by the next business day following receipt of your Claim Report. If you are not contacted within that time, please call us to assure that your e-mail has arrived successfully.

Do you need to submit a personal claim? Click here for the personal claim form.

*Required
*Name of business:
*Business street address:
*Business city:
*Business state:

*Business ZIP:
*Business phone:
*First name of contact person:
*Last name of contact person:
*Phone number of contact person:
E-mail address for contact person:
Policy number:

*Date of loss: 

   

*Type of loss (i.e. robbery, wind damage, fall):

  

*Circumstances surrounding the loss:

  

*Your best estimate of the dollar amount of the loss:
(Please do not use commas or decimals)

 $ 
Comments: