Claim Reporting and Insurance Forms
PACIF members: To report an injury, accident, damage,
loss, or potential loss, click on the appropriate box below.
Not sure which box to click? Please call Trisha Clark at 1-800-649-7915.
Other PACIF Forms
In the list below, the pencil icon shows the forms that can be filled in and submitted completely online. Use the PDFs as indicated for each form.
Unemployment Insurance (UI) Trust
BlueCross BlueShield of Vermont (BCBSVT) — Direct or via AIV
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To request more information about VLCT's Risk Management Services, complete and submit this form online.
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Complete and submit online for group life, short-term disability, and long-term disability.