SUBMIT A NEW ASSIGNMENT

If you are submitting a new Auto, General Liability or Worker's Compensation Loss assignment, please CLICK HERE to e-mail all the claim information to us.

If you would like to complete the Employer's Report of Occupational Injury or Illness Form on line and forward to us via E-Mail, you will need the full version of Acrobat. E-mail to us at assignment@southlandclaims.com. Otherwise, you can complete the form on-line, print it and fax it to us or scan it to your system and send it via e-mail as an attachment. For instructions on how to submit this document, please CLICK HERE.

You will receive a response the next business day from the assigned claims adjuster / examiner.  Thank you.