Forms / Applications

Claims Status Request

You should have contact information for your claims adjuster at Great American (D&O Claims) or York (Third party claims administrator for AIG (AIU Holdings Inc.) claims). Feel free to save time and contact them directly for claims status. If you are not sure who your contact is, don't hesitate to complete the following information and we will put you in touch.
Claims Status Request Form
Named Insured:
Claim Number:
DOL:
Line of Business:
Info Requested:

If you are not the current broker-of-record we require an authorization signed by the named insured to release this information to you. Please print this screen and fax it with the written authorization to 212-297-3131; Attention: Claims Status Update Request, or email it to DPGClaims@distinguished.com.

Agent/ Broker Requesting Info
Name:
Company:
Phone #:
Fax#:
Email:

The Distinguished Programs Group
6 East 43rd Street, New York, NY 10017
1-212-297-3100