Payment Options

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  (Pagar Por Telefono)
  USA: 24/7
  Canada: M-F 8am-8pm ET


Report a Claim
You can easily report a claim online.

Report a claim

Select another resource for help:
* For policyholders that have received an invoice directly from USLI
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Download our mobile app to make mobile payments. Available for iPhone or Android.*

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Report a Claim

Please complete all necessary fields below.

Policy Number*
Insured Information
Named Insured (Policyholder's Name) Country
Street Address 1 Street Address 2
City State/Province/Region Zip/Postal Code
Insured Contact Name Phone 1 Phone 2
 .   . 
E-Mail Confirm E-Mail
Date and Time of Loss
Location of Loss
Street Address
City* State/Province/Region* Zip/Postal Code
Loss Description Describe what happened*

Witness Information
Witness One
Name:       Phone:       EXT: 
Witness Two
Name:       Phone:       EXT: 
Party Information
Name edit
Injured/Damaged Parties*

addAdd Injured/Damaged Party
Reporter Information
Reported By*
Reporting Relationship*
Report Date: 1/19/2020
Contact Phone Number:*
Contact E-Mail Address*
Confirm Email Address*

* Required Field