If you have experienced a serious loss, please call our 24-hour Serious Claims Service at 866-287-5019 Reporting Information Are you an agent, insured or someone else?AgentInsuredOther *Your Name *Insured Contact Name *Insured Contact Phone *Policy Number Alt Insured Contact Phone *Agency Name *Insured Contact Email Insured Business Name *Confirm EmailLoss Information *Date of Loss Location of Loss (include address, city, state) Description of Loss Police/Fire Department Loss Reported ToDamages Properties damaged: descriptions, property owner names and contact information Injured parties: names, contact information, and nature of any injuriesWitnesses Names and any contact information gatheredAdditional Comments Any additional information to provide not captured above
