Thank you for choosing to submit a new assignment to Loss Solutions Group!  Please complete the form below with your contact information, claim information and assignment information.

If you’d prefer to speak with a Loss Solutions Group Client Service Specialist, please contact admin@LossSolutionsGroup.com or call 866.899.8756 ext. 1 and we’d be happy to help!


Client/Adjuster Details


First Name (required)

Last Name (required)

Company (required)

Phone Number (required)


Claim Details


Claim #

Named Insured

Insured Contact Name

Insured Contact Business Phone

Insured Contact Mobile Phone

Insured Contact Home Phone

Insured Contact Email

Date of Loss

Loss Location


Assignment Tasking









Additional Claim/Assignment Notes:


Do you have claim documentation or photos?

NoYes, I'll email them to newclaims@losssolutionsgroup.com