Electronic Claims Form

Please be sure to complete fields marked with *. Click on Submit when ready to send.

  • *Your Name:
  • *Email Address:
  • Company Name:
  • Address:
  • Address 2:
  • City, State, Zip:
  • *Phone:
  • Fax:
  • Current Insurer:
  • Expiration Date:
  • Claim Information:
  • Policy Holder:
  • Insurance Carrier (if known):
  • Policy Number (if known):
  • Date of Loss:
  • Location of Loss:
  • Description of Loss:
Company Email:

Contact Us

Other Key Services

Auto/Home

York-Jersey Underwriters represents 15 auto and homeowner insurers. We always provide multiple quotes from a variety of companies to ensure you are receiving the best service and highest value. You can be assured that your independent agent has your best interests in mind.

Business

From Wall Street to Main Street, we insure businesses of all sizes. Whether you are a retailer, wholesaler, contractor or manufacturer, we have the expertise to tailor your coverage plans to meet your particular needs. By representing many of the leading national and regional insurance companies, we can design a comprehensive protection plan that works for your bottom line.

Life/Health Employee Benefits

York Jersey Underwriters also specializes in employee benefits. Our organization has a team of employee benefit specialists who have over 30 years of combined experience with group benefits. Our employee benefit specialists focus on reducing employer cost without decreasing employee benefits.

Mortgage Field Services

York-Jersey Underwriters has insured the mortgage field service industry since 1983 and has the endorsement of the National Association of Mortgage Field Services (NAMFS). This is the oldest, largest and only not-for-profit field service association in the country.