Insurance Adjuster Forms Submit a Claim for Investigation

Insurance Claims

Insurance adjusters may submit a claim for investigation by filling out the form below.

We will contact you within one business day to set up an investigation according to your stated requests.

Claims Adjuster's Info

Claims Adjuster Name(Required)
Claims Adjuster Address(Required)

Insured's Info

MM slash DD slash YYYY
Address of Loss(Required)

File Attachment(s)

Drop files here or
Max. file size: 128 MB.

    Reporting Instructions to Harms Engineering

    Reporting Instructions to Harms Engineering(Required)

    Authorization To Proceed

    Authorization To Proceed(Required)