General Surety Bond Claim

General Surety Bond Claim

This form is for the submission of a claim on a surety bond. If you are the claimant and are owed money by a principal that is bonded by Allegheny Casualty Company, please complete the following claim form.

If you are a shipper or carrier and you are owed money by a freight broker/freight forwarder, please complete the Freight Broker (BMC-84) Bond Claim Form located here: Freight Broker (BMC-84) Bond Claim Form – Allegheny Casualty Company.

Any BMC-84 (“freight broker”) bond claims submitted through the General Surety Bond Claim form will not be considered. You will be redirected to the website to resubmit your BMC-84 (“freight broker”) bond claim if you mistakenly submit your freight broker claim inquiry using the General Surety Bond Claim form.

All fields marked with an asterisk* are required.

    Claimant Information

    The company/person filing the claim is considered the "Claimant." The contact information below should be that of the Claimant. The provided information will be used to contact you regarding the claim.

    Principal Information

    The company/person responsible for facilitating the transaction and for issuing payment upon completion of the work or service provided is the "principal." The provided information should be that of the principal.

    Claim Information

    Total Claim Amount Owed to you (claimant)

    Please provide as much information as possible.

    • Nature of the transaction between you (claimant) and the principal.
      • Example: contract for purchase of goods with information about the types of goods purchased.
      • Example: contract for services provided with information about the types of services provided.
    • Date of Transaction/Contract.
    • Date of the Incident, including date of principal’s failure to pay (if applicable).
    • Any attempt(s) to reach the principal and any response(s) received.

    Upload the Documentation Surrounding this Claim

    Upload a copy of any documents referenced in the "description of claim" above. This includes but is not limited to: agreement(s)/contract(s), invoice(s) and correspondence.

    Contact information for general claim related matters:

    Email: [email protected]
    Phone Number: (973) 200-6496
    Fax Number: (973) 339-5884
    Mailing Address: 1 Baxter Way, Suite 130, Westlake Village, CA 91362
    Attn: James Portman, Chief Legal Officer

    Our claims team is committed to providing you with the fastest and most efficient claims process possible. Whether you would like to file a new claim or inquire regarding an existing claim, simply call our team directly at (973) 200-6496. You satisfaction is always our number one goal.

    Skip to content