Filing a claim online is fast and easy! It is important to file your claim as soon as possible to get the process started. Please fill out the form completely and accurately, and we will contact you as soon as possible.
Please, only file your claim one time. Submitting the same claim multiple times will slow down the processing time of your claim.
Contact Information
This is the contact information for the person filling this out.
Policy Information
Loss Information
Miscellaneous Information
Confirmation
Name
First Name
Last Name
Relation to Insured (Type 'Self' if you are the insured)
Agent Information
Agent Name
Agent Phone Number
Agent Email
Basic Information
Policy Number
Insured Name
Insured Phone Number
Insured Email
Best Time to Contact
Was there a mortgage on the property when the loss occurred?
If Yes, Mortgagee Name
Policy Address
Street Address
Address Line 2
City
Postal Code
Loss Date/Time
Date of Loss
Time of Loss
Loss Details
Location of Loss (If different than the Policy Address)
Is It Safe To Remain In Your Home?
Reported to Police or Fire Department
Type of Loss
Describe The Loss
Outside Insurers
Other Insurance Covering the Property?
If Yes, Name of Insurance Company
Additional Comments
Additional Comments
Certification
Disclaimer: This claim will be reviewed and contact will be made as soon as possible on the next regular business day following receipt of this notice. We may not receive this claim promptly if the report is being completed after hours or on weekends or holidays. Claims will be prioritized by severity, so that policyholders who are unable to live in their homes will be contacted first. This reporting capability is solely for the convenience of filing a claim .
