General Insurance Agency, Inc.

CLAIM FORMS AND CLIENT SERVICES

Here is the PDF file explaining the Federal requirements taking effect in November 2008 concerning highway incidents and responses, showing the types of vest acceptable. Click Here

Pennsylvania Tax Credit Information Sheet. Click Here

Take the National Fire Service Seat Belt Pledge. Download the Form

PROVIDENT

NOTE: After completion, please print and fax to the General Insurance Agency at (267) 640-0916 for processing. IF YOU NEED ASSISTANCE, PLEASE DO NOT HESITATE TO CALL US AT 800-882-0801 or click on the HELP link at the bottom of this page.

Accident & Health Policy Forms

Beneficiary Designation Form

Guide to filing a Provident A&H Claim

Accidental Death & Dismemberment (AD&D) Forms

Beneficiary Designation Form

Accidental Death Claim Form - Call us for assistance in completing

Group Term Life Forms

Beneficiary Designation Form - Send Completed Forms to us instead of Provident

Death Claim Form - Call us for assistance in completing

Misc. Forms

Federal Autopsy Protocol

ESIP