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Claim Notification

This e-mail request form is intended to allow Adams & Associates International® to begin the consideration and processing of your claim.It may be necessary for you to fill out a specific claim form depending on the claim type you have. Please be sure to include a fax or mailing address should we need to send you a specific claim form.

PLEASE NOTE: Claims are not deemed received by voice mail, fax, or email requests until you have written confirmation from an AJG Claims Department staff member.

First Name
Last Name
Your Address
Address 2
City
State Zip:
Mission Organization
Policy Number
(if known)
Country of Origin
(if applicable)
Email Address
Phone
Fax
Date of Claim
Type of Claim  
  Property Policy #: 
  Volunteer Travel Enroll #: 
  Medical Policy #: 
  Accident Policy #: 
  Automobile Policy #: 
  Other If Other: 

Please give us a brief description of what happened, including dates, places, etc. We will advise you which Claims Form is to be used.

Adams and Associates International® - Missionary Insurance Services is our Specialty

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Telephone: (803) 758-1400  |  Toll Free Client Services Line: (800)922-8438  |  Fax: (803) 252-1988

Please note that insurance coverage for any line or class of business can not be effective until a written acknowledgment is issued from Adams & Associates International�. This site is presented as a brief overview of our programs and services. For coverage specifics, please refer to the actual policy.
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