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It may be necessary for you to provide us additional information
about your Auto or Homeowners Loss. A Premier Claim Representative may instruct you to obtain a form to provide this additional information. You will be directed to this area of our web site should you wish to expedite the process of your claim to obtain a form. If you have any questions or need assistance please see your Premier Agent or Premier Claim Representative. Accident Report Affidavit of Vehicle Theft Application For Benefits Bailment Statement Forgery Affidavit-Corporate Forgery Affidavit - Individual Fraud Advisory (Albanian) Fraud Advisory (English) Fraud Advisory (Portugese) Fraud Advisory (Russian) Fraud Advisory (Spanish) Fraud Advisory (Vietnamese) Lost Check Affidavit - Corporate Lost Check Affidavit - Individual Medical Information Consent Receipt and Release Repair Certification Wage and Salary Certification Witness Statement |
The Premier Insurance Company of Massachusetts
One Chestnut Place, 10 Chestnut Street, Suite 300, Worcester, MA 01608
Phone: (508) 751-4200 Fax: (508) 751-4590
www.premierins.com
The Premier Insurance Company of Massachusetts is licensed to write property and casualty insurance in Massachusetts
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