Property Claim Form

Please complete this form as soon as possible after discovering property damage or loss. After the form has been submitted, the office will notify you and start the claim process on the next business day.

1. Policy and Claim Information

2. Insured Information

Preferred Contact Method

3. Loss Details

Kind/Cause of Loss *
Was the Property Occupied?
Was Emergency Service Contacted?

4. Description of Loss and Damage

5. Property and Coverage Information

Type of Property
Mortgagee/Lienholder

6. Mitigation and Temporary Repairs

Was action taken to protect the property from further damage?

7. Reporting Party

Certification: By submitting this form, I certify that the information provided is true and complete to the best of my knowledge. I understand that any false, incomplete, or misleading information may affect claim handling and coverage determination.