# AFFILIATED FM INSURANCE COMPANY
# APPALACHIAN INSURANCE COMPANY

## UMBRELLA & EXCESS CASUALTY CLAIM REPORTING PROCEDURE

The initial report of any occurrence likely to involve a claim against an Affiliated FM or Appalachian Insurance Company must be reported directly to our Company. When any doubt exists that a claim could involve us, it should be resolved by reporting the claim to our Company to satisfy the policy reporting requirements and protect the insured's interests.

All reports should identify the insured, provide a description of the occurrence, and include pertinent correspondence and documents. All reports should be sent to:

- **Affiliated FM Insurance Company**
- **Appalachian Insurance Company**
- **Loss Claims Department**
- **P. O. Box 7500**
- **Johnston, R. I. 02919**
- **(401) 275-3000**

Please have the enclosed acknowledgement completed by the insured's employee responsible for claims under this policy and return the card to us.