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Step One: Complete Form
Step Two: Review and Submit
Step Three: Finish
Welcome to New Claim Notification Form from SWEU.

For fast service on your new claim notification complete the form below and hit the “Step Two” button. Your submission will be electronically delivered to SWEU.
 
Insured:
 
Cover Note No:
Well Name:
Location:
Date of Loss:
Description of Loss:
Insured Contact  
Name:
Phone:
Email:  
Agency Contact  
Name:
Phone:
Email:  
    (You will get a summary page to review before submitting)