Report a Claim

Fill out the form below to submit a claim to Illinois Casualty Company. By submitting this form, you acknowledge that the information you have submitted regarding your claim or loss notice is accurate and detailed to the best of your knowledge. 
 
You may also report a claim by phone to 800-445-3726 or 309-793-1700, by email to claims@ilcasco.com, or Fax to 309-793-1707.


Policyholder Claims Contact Information:
Information regarding this claim:
,
,
:

Property (Damage to property owned by you)

Liability (Damages and/or injuries to other and/or their property)

**Workers’ compensation (Injuries to your employees)

Lawsuit

Cyber Breach

Unknown

* Required field.

Submit
Clear Form

NOTE:
- Any person who knowingly files a statement of claim containing false or misleading information is subject to criminal and civil penalties.
- Applicable in Minnesota: A person who files a claim with intent to defraud or helps commit a fraud against an insurer is guilty of a crime.
- Applicable in Indiana: A person who knowingly and with intent to defraud an insurer files a statement of claim containing any false, incomplete or misleading information commits a felony.
- Applicable in Arizona: For your protection Arizona law requires the following statement to appear on this form: Any person who knowingly presents a false or fraudulent claim for payment of a loss is subject to criminal and civil penalties.
- Applicable in Colorado: It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance, and civil damages. Any insurance company or agent of an insurance company who knowingly provides false, incomplete, or misleading facts or information to a policyholder or claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard to a settlement or award payable from insurance proceeds shall be reported to the Colorado Division of Insurance within the Department of Regulatory Agencies.
- Applicable in Ohio: Any person who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud.
- Applicable in Pennsylvania: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties.
**  Minnesota Health Care Providers should contact the Claims Department at Illinois Casualty Company at 800-445-3726 to obtain
the claim number for an employee claim. The claim number should be submitted as follows:
Claim Number: The claim identification number is reported in the 5010 ASC X12 837 TR3 as follows: Loope 2010 CA Patient Name REF Segments= Property and Casualty Claim Number REF01=Y4 (qualifier) REF02=Claim Number Reference Source: 5010 ASCX12 837 TR3 Implementation Guide available at www.wpc-edi.com
- For questions related to electronic transactions please contact: Jopari Solutions, 1855 Gateway Blvd, Suite 500, Concord, CA 94520, 800-630-3060, option 3 or www.jopari.com/contact-us

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