Claim Form

Welcome to the Insurcomm claim form. This form is your one-stop for submitting notification about a claim to Insurcomm. As an insurance professional, Insurcomm is providing you with this quick and efficient way to report a claim on behalf of your client.

If this is an emergency we ask that you call our 24/7 helpline first at 844-424-9283.

Please enter the following information and we will call your customer to set up an appointment and get their home or business back to normal.

Agency & Agent Name*
Customer Name:*
Agency/Agent Phone Number:*
Customer Phone Number:*
Agent Email:*
Customer Email:
Loss Address:
Street Address Address Line 2 City State ZIP Code
Type Of Loss*
- Fire
- Water
- Storm
- Mold
- Other
Covered Loss?
- Yes
- No
Adjuster & Claim Number If Known:
Additional Notes If Any:
CAPTCHA

Please note:

Insurcomm strives to respond as quickly as possible to all forms of property loss. During times of adverse weather, it is common for response times to be longer. We will do all that we can during these times to respond as quickly as possible.

Emergency mitigation can be started without power as long as water is turned off from the home.

Welcome to the Insurcomm claim form. This form is your one-stop for submitting notification about a claim to Insurcomm. As an insurance professional, Insurcomm is providing you with this quick and efficient way to report a claim on behalf of your client.

If this is an emergency we ask that you call our 24/7 helpline first at 844-424-9283.

Please enter the following information and we will call your customer to set up an appointment and get their home or business back to normal.

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Skilled Professionals