Submit a Claim - ISERA - Claims Direct Access

To begin the claim filing process, please fill out the form below.

Claims Direct Access will work with highly experienced claims experts to ensure you receive frequent communication, professional advice, and professional representation throughout the entire process.

As an alternative to the online form, you can print/download the PDF version of the incident reporting form. When filled out, please send to info@claimsdirectaccess.com.

IMPORTANT NOTICE: It is your contractual responsibility to report any Claim, Loss or lawsuit, or any incident or event which could reasonably lead to a Claim, Loss or lawsuit, directly to us as set forth in the Policy. If for any reason you are unable to use our Online Claims App for this purpose, it is still your responsibility to report any such Claim, Loss, lawsuit, incident or event to us as set forth in the Policy by another method such as by facsimile (Toll-Free) at 1-877-452-6909, by email at info@claimsdirectaccess.com, or by telephone at 1-877-585-2849. Your failure to do so may jeopardize any coverage as set forth in the Policy.

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Personal Information:

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Today's Date*

First Name*

Last Name*

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Your Home/Business Address*

ZIP Code*

State*

Phone Number*

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Policy Information:

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Date of Incident*

Policyholder Name*

Policyholder Address*

Policyholder State*

Policyholder City*

Policyholder ZIP Code*

Policy Number

Description*

Witness Information:

Witness Information

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Photos:

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To begin the claim filing process, please fill out the form below.

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