Ohio FAIR Plan Underwriting AssociationOhio FAIR Plan Underwriting Association
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OMSI Claims Procedure

To Report a Claim

A claim can be reported via:

  • The form below
  • Faxing information to 614-839-1468

A copy of the property owner's declaration page should be submitted with the claim. Please call 614-823-6008 for claims emergencies.

Property Claim Notice

* denotes required fields                                    
Insured Name & Address
First Name: *
Last Name: *
Address: *
City *
State: *             Zip Code: -*
Phone: --*  Ext.    Type: *
Property Address
Property Address: *
City: *
State: *             Zip Code: -*
Contact Information
First Name: *
Last Name: *
Phone: --*  Ext.    Type: *
Loss Information
Date of Loss: * (mm/dd/yyyy)
Agency Information
Name: *
Insurance Company Information
Company Name: *
Reported By
Name: *
Phone: --*  Ext.    Type: *
Email: *
Description of Loss*

Please attach a copy of the insured's declaration page and any other documentation to support this claim. You may attach as many files as you wish, but they must be attached one at a time.

Note: Each attachment must be smaller than 4 megabytes and must be in one of the following formats:

  • GIF
  • BMP
  • PDF
  • Joint Photographic Experts Group
  • Graphic Interchange Format
  • Tagged Image File Format
  • Bitmap
  • Portable Document Format
  • Microsoft Word Document

Attached Files:

(No Files Attached)
Click the "Browse" button to select a file you would like
to attach to this application. After you have selected a
file, click the "Attach File" link to attach the file you
selected to this application.
Attachment Location: 
                                 Attach File
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