Central Insurance
Agency
201 South 1st Street
Ishpeming, MI  49849
906.485.5585
PLEASE NOTE:  After submitting your information you should follow up with your agent to
ensure receipt of this message and check claims status.
Personal Information
* Full Name:
* Street Address:
* City, State, Zip:
* Phone
(ex:  xxx-xxx-xxxx):
* E-Mail Address:
Policy Type:
Date of Loss:
 Place of Loss:
Detailed Loss Information:
Please Provide a Detailed Description of Your Claim
Contact Numbers & Times:
Please Provide Contact Numbers & Best Time(s) to Reach You