Client Portal Login GIVE US A CALL! (800) 443-8338 HOME PLACE AN ACCOUNT MAKE A PAYMENT CONTACT US IN THE NEWS Place a Subrogation Account Client Name Assigned By Phone Date Month 1 2 3 4 5 6 7 8 9 10 11 12 Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Insured Name Claim Number Loss Location Date of Loss Other Deductible ($) Property and/or Collision Damage ($) PIP and/or MEDPAY and/or UMBI ($) Rental ($) Salvage ($) Towing & Storage ($) Total Claim Amount ($) Responsible Party Name First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone Additional Responsible Party Please only fill in this section if applicable. Name First Last Address Street Address Address Line 2 City Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Armed Forces Americas Armed Forces Europe Armed Forces Pacific State ZIP Code Phone Submitter Information Email Please upload all supporting documentation. Files cannot exceed 8MB. Drop files here or Comments or questions? If you are experiencing problems uploading documentation, please send them in an email along with your case number to TGACOL@TGALTD.COM. Contact Information (800) 443-8338 (631) 261-8896 TGACOL@tgaltd.com P.O. Box 30 East Northport, NY 11731 HOME PLACE AN ACCOUNT MAKE A PAYMENT CONTACT US PRIVACY POLICY IN THE NEWS

Client Portal Login GIVE US A CALL! (800) 443-8338 HOME PLACE AN ACCOUNT MAKE A PAYMENT CONTACT US IN THE NEWS Contact Us Thank you for your interest in TGA! If there is any other way we can assist you further, please don't hesitate to ask! Name* First Last Phone* Email* Questions or Comments?* (800) 443-8338 (631) 261-8896 TGACOL@tgaltd.com P.O. Box 30 East Northport, NY 11731 Contact Information (800) 443-8338 (631) 261-8896 TGACOL@tgaltd.com P.O. Box 30 East Northport, NY 11731 HOME PLACE AN ACCOUNT MAKE A PAYMENT CONTACT US PRIVACY POLICY IN THE NEWS