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Incident Report

You can report incidents 24 hours a day, 7 days a week by filling out the brief form below.

If you need immediate assistance from your claim manager, call 206-812-3850.

The form is to notify to your claim manager and is not shared with anyone else. Your claim manager will contact you by phone to obtain any additional information that may be required. After completing the required data entry fields, the form cannot be printed. Please contact your claim manager during business hours to request a copy of the report. Once the submit button has been clicked you cannot change data on the form. If you make an error, resubmit the incident.