EIM Insurance Association
506 1st Avenue South
Mt. Vernon, IA 52314
319.895.6121 fax

Report a Claim

If you are unable to contact you agent, you may also submit your claim online. For Eastern Iowa Mutual to be able to process your claim, please complete the following online form and click the submit button at the bottom of the page.

Policy Number (if available):

Policyholder Name:

Date of Loss:

Time of Loss:



State / Zip:


Contact Person:

Email Address:

Day Phone:

Night Phone:

Cell Phone:

Fax Number:

Pager Number:

Best Time to Call:

Reported By:

Where Did the Loss Occur?:

Description of Loss:

Describe Damages:

Investigating Department:


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