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Commercial General Liability Claim

Did something happen at work or job site that hurt someone or damaged something? Fill out the form below as well as you can and a Leavitt Group claims member will get back to you within a day. Fill in what you know, and skip what you don’t or doesn’t apply. We have the experience to assist you.

Serious or fatal injuries

Follow the Emergency Claim Reporting Instructions on the claims center page.

Non-serious or non-fatal injuries

Rob Regur, CISR
Leavitt United Director of Risk & Claims Services
(559) 256-2540 | rob-regur@leavitt.com

General liability incident report form

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Coverage cannot be bound or altered online. Complete the form below to have a service representative contact you to finalize your request.