forms

Claims Forms


When submitting a claim to Bass Underwriters, please forward a completed ACORD Loss Notice to our claims department at claims@bassuw.com or via fax to 954-316-3128. Please note we are unable to submit the claim without the ACORD loss notice. To insure that the claim is handled most expeditiously, please include as much detail as possible on the loss notice.

Loss runs:
When requesting a Loss Run, please include the name of the insured; policy number(s) and policy period(s) and forward this information to our claims department at claims@bassuw.com or via fax to 954-316-3128 . Please note that in following our usual protocol, loss runs may take up to a week to retrieve due to various carriers response times, so please allow this time in requesting your loss runs.