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203 Main St. P.O. Box 199
Arlington, WI 53911
Phone: 608-635-4754
Fax: 608-635-8075

Mission Statement: Arlington Mutual Insurance, A Wisconsin Company,
since 1873 – providing quality insurance, friendly service and personalized protection through partnerships with our agents.

ARE YOU A LICENSED AGENT? ARE YOU MOTIVATED? WE ARE HIRING!! Contact us today for details!

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With Arlington Mutual Insurance Company, it's easier than ever to report a new claim. If you have any questions at all, contact your agent or call us at (608) 635-4754. You may use the online claim form below to quickly submit a new claim to us. Please complete the form as thoroughly as possible:

Contact Name

Contact Phone

Contact Fax

Contact Email

Contact Mailing Address

Contact Insured

When To Contact

Agent

Insured Name

Insured Mailing Address

Insured Date Of Birth

Insured SSN

Insured FEIN

Insured Marital Status

Insured Primary Phone

Insured Secondary Phone

Insured Primary Email

Insured Secondary Email

Spouse Name

Spouse Mailing Address

Spouse Date Of Birth

Spouse SSN

Spouse FEIN

Spouse Marital Status

Spouse Primary Phone

Spouse Secondary Phone

Spouse Primary Email

Spouse Secondary Email

Date Of Loss

Time Of Loss

Location Of Loss

Loss Location City, State, Zip

Loss Country

Describe Location Of Loss If Not At A Specific Address

Police Or Fire Department Contacted

Report Number

Probable Amount Entire Loss

Description Of Loss And Damage

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