You can use this form to file a claim with PECO.
This document is provided in Adobe Acrobat format. If you do not have Adobe Acrobat Reader, click below for a free copy.
- Print out a copy and fill in the information requested below.
- Mail the completed form directly to our office at the following address: PECO, Claims Division, S16-1; 2301 Market Street, Phila., PA 19101
- Or, fax the form to us at 215-841-4919.
Once this form is received in our office, you will be contacted by one of our Claims Adjusters at your daytime telephone number.
