Gallagher Benefit Services, Inc.

CLAIM FORMS

For your convenience, the forms available on this page may be downloaded, filled in, and e-mailed back to us.

ACORD Reader
To use any of the ACORD documents on this page, you MUST have this file installed on your computer. To download, left-click on the filename and enter the information requested. Once the installation program is downloaded, run it, and follow the on-screen instructions.

ACORD Form #4 (Worker's Compensation Form)
To download, right-click on the filename, then choose Save Target As....

The Cincinnati Insurance Companies
Employee's Report For Worker's Compensation
To download, right-click on the filename, then choose Save Target As...
This form is in Microsoft Word (R) format.