Homeowners Insurance — Report a Claim

Please note that submitting a claim from this Web site does not confirm coverage or authorize payment.  An agency representative will verify your coverage and contact you to complete the claims process.
 
Policy Number   (if you know it)
Name on Policy
Contact Information

Name
Home Telephone
Work Telephone
Email Address required
Best time to call you
Authority Contacted
Police or Fire Department
Report Number
Claim Information
Date of Loss
Location of Loss
Cause of Loss
Describe the damage to your property
Temporary shelter required? Yes     No
Windows required board-up? Yes     No
Injuries
Reminder:  If more than two people are involved, please contact our agency directly to report the claim.
Information about person injured:
Name
Address
Telephone Number
Nature of injuries
Cause of injuries
Information about person injured:
Name
Address
Telephone Number
Nature of injuries
Cause of injuries
   
Comments and/or other information