You are:

Homeowner

Business Owner

Landlord

Affected Property Location

What type of damage do you have?(Required)

Hurricane/Tropical Storm Damage

Fire Damage

Mold Damage

Water Damage

Flood Damage

HVAC Damage

Vandalism/ Theft

Other

What best describes the Issue with your Claim?

Questions about opening a claim

Claim was opened but was denied

Claim was opened but was underpaid

How many rooms/parts of house are affected?(Required)

In a few words please describe what parts of your house are damaged

Date

Type of Location:(Required)

Zipcode:(Required)

Are you the only person on the policy?

Yes

No

Names of people on the policy(Required)

What is the name of your insurance company?

Do you have a mortgage on the property?

Yes

No

When was the property paid off(Required)

What is the name of your mortgage company?

Name

First Last

Preferred Contact:(Required)

E-mail

Text

Call

Email(Required)

Phone(Required)

Policy Declaration Page:

Drop files here or

Max. file size: 256 MB.

Pictures of Loss:

Drop files here or

Max. file size: 256 MB.

Insurance company estimates and letters

Drop files here or

Max. file size: 256 MB.

Any available contractor estimates:

Drop files here or

Max. file size: 256 MB.

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