Report a Claim

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.

Type of Claim

What is your relationship to the SECURA policyholder?

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.

Your Name

Your Email address

Phone number

Phone type Home Cell Work

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

SECURA Insurance Policy number

Policyholder name

Policyholder Phone Number

Claims details

Date of Loss

Where loss took place

Street

City

State

Zip code

Description of Loss

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.