General Liability: If you are involved in an incident that may give rise to a liability claim (for example, a claim arising from someone being injured or property being damaged), or if you receive a legal summons or a letter from an attorney as a result of such an incident, please report this information immediately to the American Specialty Express Program Administrator at American Specialty Insurance & Risk Services, Inc.

To report a claim or potential claim, please complete an Incident Report Form.

Keep a copy for your records and send the completed form to:

American Specialty Insurance & Risk Services, Inc
7609 W. Jefferson Blvd, Suite 150
Fort Wayne, IN 46804
Customer Service: 800-566-7941
[email protected]

Participant Accident: If you sustained an injury while participating in a covered activity and participant accident coverage is in place, please follow the instructions in the Incident Report Form below. Note the form must be signed by a representative of the policyholder.

To report a claim or potential claim, please complete an Incident Report Form.

Keep a copy for your records and send the completed form to:

Health Special Risk, Inc.
8400 Belleview Drive, Suite 150
Plano, Texas 75024
Customer Service: 800-328-1114
[email protected]