Report an Auto and General Liability Claim
These services are available to all MCSIP members except Fire & Rescue Services and City of Gaithersburg.
Auto and General Liability claims, can be reported using CareMC, e-mail, fax, or telephonically. Before using any of the methods, make certain to have the following information:
• Agency name, address and location code
• Claimant information, please include phone number and address
• Date the accident occurred
• Location of the accident and any witnesses
• Date and time client was notified of the incident
• Any additional relevant information
View the Location Code Directory here
Motor Vehicle and Liability Accident Notice Form | Download here
This form is designed to help you document all of the necessary facts of a liability or automobile accident. This form should be used by Program Supervisory Personnel only. Once completed please follow Reporting Methods and submit by email or fax.
Claims can be sent via e-mail to GM-RIVA-Accident_Reports@Corvel.com. You must follow these procedures when sending:
• In the Subject Line you MUST have: Montgomery County Self Ins Property
• In the body of the e-mail, include the standard report information above
• Provide your name and phone number
Fax the report to 866-777-1668 via the Network. If reporting by fax, please include the fax cover sheet. Download Liability Fax Cover Sheet. Make sure the items you are faxing are clear and legible. The first report representative will receive your fax and submit the results electronically to the handling MCSIP claim office.
Call 888-606-2562. The phone will be automatically answered “Montgomery County Self Insurance Program, first report of injury.” A telephonic first report representative will receive your call and prompt you through the questions necessary to complete the report.