Home About Us Coverages Find an Agent Employee Links Contact Us
Agent Services
Customer Care
Please Select a State Below

Report a Property/Boat Claim
Customer Care
Customer Care Home
Claims Reporting
Contact Information
Last Name *
First Name *
Phone Day *
Phone Evening *
Email Address *
If you would like to receive a return e-mail with your claim number, please provide your e-mail address.
Policy Holder Information
Policy Number
Policy Holder - Name
Policy Holder - Phone
Policy Holder - Address
Policy Holder - City
Policy Holder - State
Zip Code
Loss Information
Date of Loss / /
Check this if Loss Location matches Policy Holder Address
Loss Location - Address
Loss Location - City
Loss Location - State
Zip Code
Type of Loss
Brief Description of Loss:
Police/Fire Contacted
Police/Fire Report Number
Police/Fire Department Name
Did Injuries Result from Accident
If Yes to above, please provide:
Name, Address, Phone Number, and Extent of Injuries of those Injured.
A Claim Representative will contact you.
 



Policies issued by Holyoke Mutual Insurance Company in Salem - Salem, MA and Middlesex Mutual Assurance Company - Middletown, CT
© 2006-2008 Middlesex Mutual Assurance Company. Click here for our privacy policy, and our terms and conditions.