Insurance Claim Form
Claim Filing Procedures to Facilitate the Claim Process
In response to your inquiry about filing a claim. Please complete the Presentation of Loss form and return the top copy to the moving company you have contracted for the move. Keep the second copy for your records.
By carefully following the claim procedures, you can assist in the timely settlement of your claim. Upon its receipt, your completed form will receive immediate attention.
- Please keep in your possession any articles that are being claimed in your loss for inspection of said property if needed. If the damaged items were placed in a container, please try to keep the container, leaving the items in the container for inspection.
- Identify the articles claimed by inventory number if possible.
- List the articles and describe the damage.
- Complete the columns labeled Estimated Weight; Original Cost; and Date Acquired, to the best of your ability. It is not necessary to complete the Amount Claimed column or obtain estimates. An assigned inspector will assist you; we will inform you if this is not possible
- If you are missing a container, try to itemize the contents and give all information regarding the weight, date and original purchase cost for each item individually, if possible.
- If your claim includes missing or possible irreparable articles worth $400 or more, please provide a full bill of sale, canceled check, or evidence of a similar nature to verify the value of the item.
- You need not submit an appraisal to support your claim. We will assign an appraiser, if necessary and inform you if we need your help.
- Please send a copy of your Bill of Lading with your claim form or keep copies of it and the inventory so the inspector can see them if necessary. The availability of the shipping documents is essential in setting your claim in a timely manner.
- In order to provide the best possible service and process your claim in a timely and efficient manner, please submit your claim as soon as possible. Your claim must be submitted within nine months after delivery of your household goods to be considered.
- Please attach additional sheets if your need more space than this form allows