An Incident Report form must be completed immediately after an accident occurs and mailed or faxed to American Specialty Insurance & Risk Services, Inc. or submitted via web form as indicated below. This holds true whether the person involved is a participant or a spectator, or whether or not you feel the incident will result in a claim.
Although you may not have sufficient information to initially answer all questions, it is important that the form be completed as fully as possible at the time of the accident. Do not delay sending in the report form; an incomplete form is better than none at all. Be certain to include your name and daytime telephone number where indicated on the form.
The form contains sections to capture information regarding injury to persons, damage to property, and accidents involving autos.
If you have any questions or need assistance regarding the completion of the Incident Report form, please call American Specialty at 1-800-245-2744.
Mail or fax the completed Incident Report to:
AMERICAN SPECIALTY INSURANCE & RISK SERVICES, INC. Attn: Claims Department Post Office Box 459 Roanoke, Indiana 46783-0459 Fax: (260) 673-1291and mail a copy to the club:
Grizzly Peak Cyclists, Inc. Attn: Incident Reports PO Box 11034 Oakland, CA 94611-0034
Get the Incident Report form in PDF format, or you can submit a report via the web. If you use the web form, please also print a copy and send it to the club address above.
If you want more information about the club's insurance coverage, please go to the insurance home page.
IN ADDITION, IN CASE OF SERIOUS INJURY TO A PARTICIPANT OR A SPECTATOR, it is important that you immediately notify American Specialty by calling 1-800-566-7941 (if after standard business hours, simply follow the automated instructions for emergency claims reporting). This hotline is active 24 hours a day, 365 days a year.
The club contact person for the insurance company is: Alan Forkosh, (510)655-4221, aforkosh@mac.com.