COVID-19 Claim Reporting Form

Save & Return

Use an account to return to saved work[Optional].

Was your business ordered to close by a government authority as a result of COVID-19 ? *
Can you document actual Covid-19 contamination to your facilities and property? *
Can you document actual Covid-19 contamination to dependent or contingent locations relating to your supply, distribution and customer chain? *
Can you document actual Covid-19 contamination to property very near your locations that impaired access to your property? *
Can you document contamination clean-up expenses. *
Did you cancel any business events, promotions, and other off-premises operational activities due to actual COVID-19 contamination? *
Have you resumed operations? *

Powered byFormsiteReport abuse