With more than 75 years of emergency service experience, Provident's dedicated and caring claims staff remains committed to timeliness and accuracy while processing your claim. It remains our goal to respond when all other products have fallen short and to treat people with the utmost respect and courtesy. Please call our office toll-free at 800-447-0360 to speak to a claim representative with any questions.

Forms

How Do I File a Claim?

• Reference Guide to Filing a Claim

First Notice of Claim Forms
The fields of these forms can be completed online but must be printed and signed prior to being returned to our office. For prompt attention, please fax the forms to our claim’s only fax line at 412-963-0148.

• Accident & Health - First Notice of Claim Form  
• New York Residents - Accident & Health First Notice of Claim Form
• Group Life & 24-Hour AD&D - Notification of Death Form

Beneficiary Forms
The fields of these forms can be completed online but must be printed and signed prior to being returned to our office.

• Accident & Health - Beneficiary Form
• Group Life - Beneficiary Form
• 24-Hour AD&D - Beneficiary Form

Federal Public Safety Officers' Benefit Information

• Firefighter Autopsy Protocol

Who to better express our commitment to service than our actual claimants:

• Leonard K. Jansen, President, VFD Relief Association of Millvale writes, "I would like to thank all of you for the help in handling our most recent claim. I know this was a most unusual case, one I hope we never have again. You were very kind in the way that you handled this claim. Provident has always been there when our department has needed help."

• Steve Smith, Jefferson Hills Ambulance Authority writes, "I have been a claimant with your company since April 27, 2000. I am writing to you to inform about what I consider some extraordinary people that are employed in your Pittsburgh office: they are Mark Schmitt and Terri Horvat. Mark and Terri have made my injury something that can be dealt with more easily. Everyone always hears stories about how badly they have been treated by their disability company or workers' compensation company. My stories are never like any of those horror stories that you hear about, and I believe this is due directly to the work of Mark and Terri."

• Lt. Al Sheppard, Beaufort Fire Department writes, "Your claims department has proved to be courteous and professional. I want you all to know how much I appreciate all that has been done for me during my recent health crisis. It would not have been possible for anyone to be more kind and considerate."