Form Library

For your convenience, we provided several forms to meet your various insurance needs.

Commercial Lines

Accident Report — Massachusetts
Please use this form to report an automobile accident in Massachusetts

Accident Report — New Hampshire
Please use this form to report an automobile accident in New Hampshire

Certificate of Insurance Request
To request a Certificate of Insurance for your commercial insurance, please complete this online submission form.

Worker’s Compensation

First Report of Loss Form

ERM-14 Form — Massachusetts

ERM-14 Form — New Hampshire

Determining Independent Contractor – 3 Prong Test — Massachusetts

Determining Independent Contractor — New Hampshire

Owner Exclusion Form — Massachusetts

Owner Exclusion Form — New Hampshire

Health Insurance

Blue Cross Blue Shield of Massachusetts

Enrollment and Change Form

Student Verification

Waiver of Coverage

Continuation Form

Continuation Election Form

Personal Lines

Accident Report — Massachusetts
Please use this form to report an automobile accident in Massachusetts

Accident Report — New Hampshire
Please use this form to report an automobile accident in New Hampshire

Operator Exclusion Form — Massachusetts
If you would like to exclude a driver from an insured vehicle on your policy, please complete this form.

Driver’s License Record Change Request Form — New Hampshire
Use this form to change the information on your New Hampshire driver’s license.

Massachusetts Registry Forms

Gift Form – Family

Gift Form – All Other

Abatement Form

Title Correction Affidavit

Surviving Spouse

Company EFT Forms

Vermont Mutual

Norfolk and Dedham

Commerce/Mapfre

Dental Insurance

Delta Dental

Individual Enrollment & Change Form

Waiver of Coverage Form

If you don’t see the form you’re looking for, contact us. We’ll be happy to help you in any way that we can!