Assign A Claim Carrier Information Carrier Acuity American International Group Allstate Ins Group America First Insurance American Capitol Assurance American Strategic Insurance Ameriprise Auto & Home American Family Insurance Group AmTrust Auto-Owners Ins Group Bankers Insurance CATO Corporation Century Fire Protection Century21 - Ron Laughlin CFM Insurance Chubb Mitigation Assignment Chubb Reconstruction Assignment Citizens Prop Ins Cp Code Blue TPA Colorado Casualty Insurance Cornerstone National Insurance Calif State Auto Grp Country Financial Insurance Cypress Insurance Encompass Insurance Erie Ins Group Farm Bureau Insurance of Kentucky Farmers Ins Group FedNat Florida Insurance Guaranty Association Florida Specialty Firemans Fund First Service Business Golden Eagle Hannahstown Mutual Ins Hartford Ins Group Hippo Insurance Services HomeOwners Choice Homesite Homewise Insurance Indianna Insurance Kettler Liberty Northwest Loggerhead Insurance MetLife Auto and Home Group Montgomery Insurance Co Mount Morris Mutual NA Risk Insurance Company Narragansett Bay Insurance Company Nationwide Allied Insurance Company Ohio Casualty Group Olympus Insurance Company PDN Select Commercial Accounts Peerless Insurance Plymouth Rock Insurance Safeco Insurance Company Service America Southern Trust Insurance Star & Shield State Auto State Farm Group Swyfft Travelers Insurance Company Universal North America USAA Group Utica National Insurance Group Vault Insurance West Ben Mutual Insurance Yellow-Roadway Other Referral Type Referral Type Restoration Comparative Estimate Mitigation Appraisal Insured/Resident Information First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### Email Is Owner Information Different? Yes No THIS IS AN ATTORNEY REPRESENT FILE. DO NOT CONTACT THE INSURED DIRECTLY. If this is an attorney represent file, please check "yes" to fill out some information about the point of contact. Yes No Policy Information Claim Reference#: Policy #: Deductible Amount: Policy Limits Dwelling Contents Other Loss Information Loss Date Loss Type Pick Loss Type Water or Steam Sewer Backup or Drain Backup Mold Fire Flood Freezing Mechanical Breakdown Ice Weight or Snow Weight Non-Emergency Repair Other Casualty Losses Hurricane Test Project Animal Liability Aircraft Burglary Collapse Collision Contamination or Pollution Earthquake Explosion Falling Object Glass Hail Heat Explosion or Contraction Landslide Lightning Mudslide Moving & Storage Mysterious Disappearance Power Interruption Power Surge Riot Robbery Sea Water Sinkhole or Collapse Smoke Subsidence Theft Tornado Trauma Vandalism or Malicious Mischief Vehicle Volcanic Windstorm All Water Causes Smoke / Fire Damage Environmental (Mold/Asbestos) Sump Pump Overflow Undefined Is this an emergency? Yes No Loss Description Adjuster Information First Name Last Name Independent Adjuster: E-Mail Address to send confirmation of assignment to: Assigned Franchise Thank you! The Skaggs Company Family Click Here Click Here Click Here Click Here
