Submit a Claim Client Information Use our easy-fill claim form to submit your claim. Submit A Claim CompanyAdjuster Email Address Street Address City ZIP Code Phone #ExtensionAdjuster NameFax #Claim Number(Required)DeductiblePolicy NumberInsured InformationName First Last Phone #Address Street Address Address Line 2 City ZIP Code Loss InformationSelect a Loss TypePropertyAutoOtherDeductibleLoss Unit typeHeavy EquipmentInland Marine / BoatMotorcycleRecreational VehicleMotorhome / CamperSnowmobileLoss Unit MakeLoss Unit ModelLoss Unit VIN (if applicable)Date of Loss MM slash DD slash YYYY Type of LossCollisionComprehensiveAnimalCargoCollapseFireFreezeHailIce/snowLiabilityLightningSmokeVandalism/theftVehicleWaterWindOtherLoss Unit LocationAddress 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.