• Get A Quote
    Get A Quote
  • Access CSR24
    Access CSR24
  • Request Insurance Certificate
    Request Insurance Certificate
  • Report A Claim
    Report A Claim
  • Make A Payment
    Make A Payment
  • Contact Us
    Contact Us
Report A Claim
Forms
Report A Claim
 

Claim Forms are only intended for customers of Clemens Insurance and should not be utilized by any 3rd party.

 

General Information
Claim Information

Auto Claim Form

Property Form

General Liability

Work Comp

Contact
Get In Touch
We'd Love To Hear From You!
Headquarters

Mailing Address:
P.O. Box 128
Bloomington, IL 61702

Street Address:
2806 E. Empire St
Bloomington, IL 61704

Telephone

309 662 2100

Hours

MONDAY - FRIDAY

8:00 AM - 4:30PM

Please note completion of any request(s) for information does not constitute the purchase of insurance. No coverage may be added, changed or bound as a result of submitting a request for information or quotation of insurance. All coverage must be confirmed by the agency in writing subject to an acceptable signed application meeting the underwriting guidelines of the Insurance Company.