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Claims Forms

Automobile Loss Report (Auto Liability and Auto Physical Damage)

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Use this loss notice if one of the following applies:

  • A member automobile was damaged.
  • ​A member automobile caused damage/injury to another person or property.
  • Someone other than a member employee was injured while in a member automobile.

For assistance completing a claim form, contact the Claims Department at (800) 456-5974.
 

Crime Loss Report 

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Use this loss notice for financial losses that arise from criminal activity such as burglary, forgery, fraud and employee dishonesty. For assistance completing a claim form, contact the Claims Department at (800) 456-5974.
 

Privacy or Security Event (Cyber) Liability Loss Report

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Use this loss notice for claims arising from a cyber security event (e.g., computer system security failure, theft, loss or unauthorized disclosure of or access to electronic Personal Information in the care, custody or control of the member). For assistance completing a claim form, contact the Claims Department at (800) 456-5974.
 

General Liability Loss Report

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Use this loss notice for third parties claiming that a member or a member employee injured them or caused damages to their property. DO NOT use this form if the damage or injury was caused by a member automobile (see Automobile Claim above). For assistance completing a claim form, contact the Claims Department at (800) 456-5974.
 

Law Enforcement Liability Loss Report

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Use this loss notice for third parties claiming they have injuries or damages caused by a member law enforcement employee (e.g. excessive use of force, treatment in the jail). For assistance completing a claim form, contact the Claims Department at (800) 456-5974.
 

Property and Mobile Equipment Loss Report

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Use this loss notice for damages to member-owned property other than automobiles (e.g. buildings, contents of buildings, mobile equipment). For assistance completing a claim form, contact the Claims Department at (800) 456-5974.
 

Public Officials Liability Loss Report

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Use this loss notice for third parties claiming injuries or damages were caused by a member employee other than law enforcement personnel (e.g., actions taken by judges, commissioners, tax assessor-collectors). Also use this loss notice for claims made by a current or former employee(s) pertaining to employment issues. For assistance completing a claim form, contact the Claims Department at (800) 456-5974.
 

Workers' Compensation Claims

To report a work-related injury or occupational illness, please use the forms and notices available on the Workers' Compensation Claims and Notices pageFor assistance completing a claim form, contact the Workers’ Compensation Claims Department at (800) 752-6301.
 

Professional Claims Examiners

TAC Risk Management Pool claims are managed by professional examiners whose primary focus is to quickly, fairly and accurately examine claims for Pool members.

In-house staff examiners handle Auto, Property, Crime and Liability claims.

Public Officials and Law Enforcement Liability claims are examined and managed by experienced lawyers who specialize in these unique exposures.

Workers’ Compensation claims are examined by a third-party administrator with management oversight by in-house claims staff.