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Click ‘Get Form’ to open it in the editor.
Begin by filling out the ACCOUNT INFORMATION section. Enter your Insured Name, Policy Number, and Contact Information including your name, phone number, and the best time to contact you.
Next, move to the LOSS INFORMATION section. Provide the Date and Time of Loss, the Address Where Loss Occurred, and a Full Description of Loss.
In the INJURED INFORMATION section, list all injured parties' names, addresses, phone numbers (home, business, mobile), date of birth, gender, description of injury, and medical facility if treatment was received.
For PROPERTY DAMAGE details, include names and contact information for affected properties along with a description of the damage. Answer questions regarding building exposure and occupancy status.
Complete the AUTHORITIES INVOLVED section by providing names, report or case numbers, county information, and any violations or citations.
Finally, add any ADDITIONAL COMMENTS that may be relevant to your claim.
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Prevention tips Contact you unsolicited. Use high-pressure tactics. Urge you to cash in an existing annuity or life insurance policy to buy a new annuity,Read more
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