

Claim Form (English)
or
Claim Form (Spanish)
Thank you for choosing U.S. Specialty Insurance Company (USSIC) as your Occupational Accident Insurance Program. Click on the link
above for your Claim Form, this is the necessary document to report a claim. By completing the reporting form correctly, USSIC will be able to handle your claims in the most efficient manner. All claims should be reported to USSIC within 20 days of the loss. This can be by phone, fax or email.
Claim Form page 1, section 1, needs to be completed by the owner operator. Claim Form page 2, section 2, needs to be completed by the Motor Carrier. If you have any questions, please feel free to contact us.
Telephone: (800) 323-8121, ask for Andrea Davis at Ext. 173
Fax: (713) 996-1224
Email: transclaims@ussic.com
U.S. Specialty Insurance looks forward to developing a long and pleasant working relationship with you.