Submit your Claim

1- Follow the link to the Claims Form
2- Fill out the Form
3- E-mail the filled Form back to us

Employee Claims Form

If you have an Employee Claim fill out this form.
When you are done, press print and save it as pdf file.

Employer Claims Form

If you have an Employer Claim fill out this form.
When you are done, press print and save it as a pdf file.

Email your Claims Form

Send the Filled Form to us at claims@brokershr.com

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