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Pennsylvania Lumbermens Mutual Insurance Company for wood products industry
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Protective Devices

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You are here: Home / Loss Control Center / Protective Devices

PLM is dedicated to the safety of your business.

We understand that in order to properly maintain your protective devices or due to unexpected problems, you may need to temporarily take them out of service.

When this time comes, please fill out the Protective Device Impairment Incident form below to document your impairment, ensure internal and external authorities have been notified, and implement proper safety steps. PLM seeks to ensure that these devices are restored to their full functionality in a timely manner so they can go back to effectively protecting your operations.

Protective Device Impairment Incident Form

Entire form must be filled out. Completed forms are forwarded to our Customer Service Department upon submission. Please enter “N/A” into any field which is not applicable.
  • MM slash DD slash YYYY
  • :
  • MM slash DD slash YYYY
  • :
    NOTE: Alert top management, production management, maintenance personnel and emergency response team that system will be down so they can take necessary safeguards.
    Includes handling and dispensing of flammable liquids and any hot work (cutting or welding, smoking, etc.)
    Example: Establish a fire watch to tour the affected area/building during the entire impairment, obtain additional fire extinguishers, hoses, and other manual firefighting equipment in affected area/building.
  • This field is for validation purposes and should be left unchanged.

Pennsylvania Lumbermens Mutual Insurance Company
One Commerce Square
2005 Market Street, Suite 1200
Philadelphia, PA 19103

Toll Free: 1.800.752.1895
Fax: 215.625.9097
CustServ@plmins.com

              
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