New Version Completly Revamped
Home
About
Our Services Page
Quote
Careers
Contact
Focus Industries
Claims
Report A New Claim
To report a new claim, please fill out the information on the form below.
To check on an existing claim click on the button, to be connected to our Cornell claims tracking system.
INSURED
Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Home Phone
*
-
-
Business Phone
*
-
-
Email
*
Comment
*
Submit
LOSS
Date of Loss
*
Location
*
Police or Fire Dept. Which Reported
*
Type of Loss
*
Commercial Property
Workers Compensation
General Liability
Professional Liability
Commercial Auto
Other
Estimated Amount of Entire Loss
*
Brief Description of Loss (Be As Specific As Possible)
*
Additional Documentation
*
Accepted File Extensions: Pdf, doc,docx
Submit
Javascript is disable -
http://www.webestools.com/
-
Navigation Buttons Generator