Assign Property Loss

Upload File

Report Within *

1 - 3 Days

3 - 7 Days

7 - 15 Days

15 - 30 Days

Confirm Assignment Receipt *

E-mail

Phone

By 1st Report

Policy Information and Coverage Details - Coverage A Limit

Insured Name and Contact Information - Insured First Name *

Type of Property Involved

Residential

Commercial

Industrial

Claim Details and Assignment Type - DOL(mm/dd/yyyy) *

Please provide as much information about the claim as possible
Required fields are marked by the * symbol
If you do not have the information for a required field, please enter "unknown"

ASSIGN A PROPERTY LOSS

Insurance Claims Management

Industry Focused ~ Relationship Driven

G. K. WYMER, INC.

Information On Other Parties - Please use the following section for identifying additional parties to the loss, such as eye-witnesses, police officers, attorneys, etc. (Not Required). - Additional Party #1

Claimant

Witness

Other

Client Information/Reporting Address - Client's Company Name *

Instructions/Other Information Regarding The Agent