Claims

Claims

At Koty-Leavitt Insurance Agency we pride ourselves in having strong relationships with our clients and that is because we feel strongly in being an advocate, it is also one of core values.

We represent most
major carriers
Multiple premium
payment options
Consulting and
Program Design
Claims…we
are your advocate

We understand that navigating through the insurance process can be a challenge and therefore we work closely with our insured's not only through the sales process but in the day to day insurance matters that affect you most.

Part of the service we provide is helping you through the claims process; dealing with a loss can be devastating such as a building burning, a car being totaled an employee being injured. We go the extra mile by making sure your claim is being set up, helping to provide a voice when working with adjusters, advocating on your behalf if you believe a claim is not being handled properly and helping to identify services that help you through the transition.

Depending on the type of claim you have you will need to provide certain information. Please click on the types of claims below for additional information you will need to provide.


Click a claim topic below to learn more:

A liability claim could result from a slip or fall at your premise, at a job site or it could involve property damage. Suppose you are a service company called out to repair a C-Arm. After your tech services the retraction component, it fails and retracts violently injuring the radiology tech and slams into the wall of the imaging room putting a gaping hole in it. This could fall under your General Liability Policy covering bodily injury and property damage.

To Report a Liability Claim please complete the General Liability Claims Report Form by clicking on the PDF below and fax to our office at (520) 571-9667 or you can call, email or fax the following information below:

  • Your Company Name
  • Date of Loss
  • Contact Name and Phone Number
  • Location of Loss (Street, City, State)
  • Authority Contacted (if applicable)
  • Description of Accident
  • Location Conditions i.e. wet, dry, cloudy, sunny, etc.
  • Were pictures taken?
  • Name, Address & Phone Number of injured party(ies)
  • Name of Hospital or Physician taken to
  • Name, Address & Phone # of any witnesses

Download Form [PDF]

An Auto Claim could take shape in a variety of forms, such as you hit a vehicle or a vehicle hits you, you could hit a property or a person, your vehicle is stolen or broken into, if you have non-owned auto liability, a claim could occur if you borrowed someone's vehicle and got into an accident, or if you have hired auto liability it can happen if you rent a vehicle and get into an accident; these are all types of auto liability claims.

Types of Property Claims are fire, theft, sewer backup; it could also include damage or loss of your contents. To Report a Property Claim please complete the Property Claims Report Form by clicking on the PDF below and fax to our office at (520) 571-9667 or you can call, email or fax the following information below:

  • Your Company Name
  • Date of Loss
  • Contact Name and Phone Number
  • Location of Loss (Street, City, State)
  • Authority Contacted (if applicable)
  • Description of Loss
  • Damage to Property
  • Police Department/Fire Department that responded (if applicable)
  • Police Report #

Download Form [PDF]

An Auto Claim could take shape in a variety of forms, such as you hit a vehicle or a vehicle hits you, you could hit a property or a person, your vehicle is stolen or broken into, if you have non-owned auto liability, a claim could occur if you borrowed someone's vehicle and got into an accident, or if you have hired auto liability it can happen if you rent a vehicle and get into an accident; these are all types of auto liability claims.

To Report an Auto Claim please complete the Auto Claims Report Form by clicking on the PDF below and fax to our office at (520) 571-9667 or you can call, email or fax the following information below:

  • Day/Date/Time AM/PM of Loss
  • Weather/Road Conditions
  • Location of Accident
  • Accident Details
  • Police Report # if one was taken
  • Your Vehicle Year/Make/VIN
  • Other Vehicle Year/Make/VIN
  • Towing Company Name & Phone #
  • Other Driver Address, Phone # and Insurance Policy Information
  • Passenger and or Witness Address and Phone #

Download Form [PDF]

If you have a work related injury to report and are insured with one of the following insurance companies you will need to contact the insurance company directly to report your claim. If you are insured with a company not shown on this list please contact your Account Executive and they will be able to assist you.

  • Allied Insurance: (800) 421-3535
  • Auto Owners: Fax Employers Report of Industrial Injury to (480) 830-8794. For additional assistance call (800) 950-3995.
  • AmTrust: (866) 272-9267
  • Colorado Casualty: (888) 298-3778
  • Hartford: (800) 327-3636
  • Travelers: (800) 238-6225
  • AmTrust: (866) 272-9267
  • Zurich: (800) 987-3373

Download Form [PDF]