Submit a Claim Client Information Use our easy-fill claim form to submit your claim. Submit A Claim Company Adjuster Email Address Street Address City ZIP Code Phone #Extension Adjuster Name Fax #Claim Number(Required) Deductible Policy Number Insured InformationName First Last Phone #Address Street Address Address Line 2 City ZIP Code Loss InformationSelect a Loss TypePropertyAutoOtherDeductible Loss Unit typeHeavy EquipmentInland Marine / BoatMotorcycleRecreational VehicleMotorhome / CamperSnowmobileLoss Unit Make Loss Unit Model Loss Unit VIN (if applicable) Date of Loss MM slash DD slash YYYY Type of LossCollisionComprehensiveAnimalCargoCollapseFireFreezeHailIce/snowLiabilityLightningSmokeVandalism/theftVehicleWaterWindOtherLoss Unit Location Address Street Address Address Line 2 City ZIP Code Loss DescriptionUpload any files relevant to your claim here (optional):Files Drop files here or Select files Max. file size: 100 MB.