Please utilize the form below to submit an assignment online.
Alternately, you can download the new matter submission form HERE.
You can also email email@example.com or call us at 866-899-8756 option 1 to submit a new assignment.
First Name (required)
Last Name (required)
Phone Number (required)
Email Address (required)
Street Address or PO Box (if you're a new client)
City/State/Zip (if you're a new client)
Site Inspection (if not selected, assignment will be handled as a desk review)
Cause of Loss / Origin
Repair vs Replacement Analysis
Replacement Cost Valuation (RCV)
Actual Cash Valuation (ACV)
Other (add notes below)
Additional Claim/Assignment Notes:
Do you have claim documentation or photos?
NoYes, I'll email them to firstname.lastname@example.org