Report your claim to SECURA

STOP! For all work injury claims please go to the Report a Work Injury page and follow the instructions there.

Requestor Contact information
If you are making this request on behalf of the policy holder, please enter your contact information below. If you are the policyholder, please enter your contact information.

Phone type

SECURA Policyholder Contact Information
Please enter the actual policyholder information below.

Claims details

Where loss took place

NOTE: If you need to submit supporting files (images, documentation, etc), please reply to the confirmation email you receive after submitting this claims form and attach those assets to your reply, thank you.