Please utilize the form below to submit an assignment online.

Alternately, you can download the new matter submission form HERE.

You can also email newclaims@losssolutionsgroup.com or call us at 866-899-8756 option 1 to submit a new assignment.


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