The following forms require Adobe Reader. Please download and complete the form pertaining to your loss in its entirety.
Mail the completed form to:
MPCGA
PO Box 531266
Livonia, MI 48153-1266
Breaking News: On August 11, 2020, the Circuit Court of Cook County, Illinois, approved the order of liquidation with a finding of insolvency for American Service Insurance Company and American Country Insurance Company. At this time do not contact MPCGA. To begin the claim adjudication process, please complete the statement of Claim and the Auto-Personal Injury Protection (PIP) forms under Claim Information.
The following forms require Adobe Reader. Please download and complete the form pertaining to your loss in its entirety.
Mail the completed form to:
MPCGA
PO Box 531266
Livonia, MI 48153-1266