CLAIM FORMS

Click on the link in the left column to open forms (PDF format)

Carrier Third Party Administrator
ACE - American Special Insurance Services.
Companion Life Assurance Resources, Inc.
Fidelity Security Special Insurance Services
GAPP Ultra North American Benefits Co.
Great American (English - Spanish) Freeman Administrative Solutions
HIPAA Medical Release Authorization Freeman Administrative Solutions
Pan American Greenwood International Insurance Services



WORKERS'
COMPENSATION
- OR -
WORKERS'
?
COMPENSATION
ALTERNATIVE
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