Electronics Claim – ClaimReporters

New Electronics Claim

1Adjuster Info

2Insured Info

3Claim Info & Attachments

Name *

First

Last

Email *

Phone *

Company Name *

Are you an Independent Adjuster?

Address

Address Line 1

Address Line 2

City

State

Zip Code

Layout

Claim Number *

Type of Loss *

Date of Loss *

Carrier Claim Specific Email *

Did the insured report any other collateral damage as part of this claim?

Desktop Review Only?

Please confirm by selecting Desktop Review Only that a Cause of Loss determination and an opinion regarding the proposed Scope of Repairs will not be provided in our findings. An on-site assessment of the claimed equipment is necessary to provide this information.

We will collect item list from insured and email scope of assignment before inspection.

Claimed Items

Select each item you would like assessed using the search bar and the dropdown menu.

Layout

Loss Description *

Client Special Instruction *

New Electronics Claim

Loss Location

We will collect item list from insured and email scope of assignment before inspection.