Property Loss Notice

Please use the form below to notify us of any loss or damage to your property insured through this agency. Please note that this form is for notification purposes only and does not constitute making an actual claim. One of our representatives will contact you shortly after receiving this notification.

Disclaimer

I understand that this does not constitute an actual claim, but is rather a notification to my agent of an existing loss or claim, and may help expedite the claim process once I have filed.

	I have read and agree with the above disclaimer.
	(Box must be checked before request can be sent)

Policy Holder Information
Please be sure to supply your phone number and email address so that we may contact you after receiving this notification.
Name Insured:
Address:
Phone #:	Work Home
Email:
Best Contact Time:

Time and Description of Loss

Time & Date of Loss

Time

a.m.
p.m.

Date

Location of Property:

Description of Loss:

Authority Notification
Were the Police or Fire Dept. Called?	Yes No
If Yes, which Authority?

Property Status
Is the Property habitable?	Yes No
If No, where are you staying:	(Address and Telephone)

Report Information
Reported by:
Title (if any):
Date:

Additional Comments

Please give any additional comments you feel appropriate for this Loss Notice.

Please click on the "Submit Form" button to send your service request.
One of our representatives will respond to your submission as soon as possible.

Refer a Friend

You made a good decision when you placed your trust in us, now we'd like you to share your experience with friends and family so that they get the insurance coverage they need, at a price they can afford.

Annual Risk Review

To get the most out of your insurance coverage for the least cost, you should submit an Annual Policy Review of your Homeowners' (Condo/Apartment) and/or Automobile policies. Click below to complete an online review. It should take less then 15 minutes!

Important Note: This Web site offers only a simplified description of coverages and is not a statement of contract. None of the information offered on the website is a guarantee that insurance will be provided or that the agency is obligated to procure insurance for the website visitor. Coverage may not apply in all states. Misstatements or omissions of relevant information can lead to price variation or even declination or rescission of coverage. For complete details of coverages, conditions, limits, and losses not covered, be sure to read the policy, including all endorsements, or prospectus, if applicable. Coverage CANNOT be bound, amended, or altered by leaving a message on, or relying upon, information in this Website or through E-Mail, Voicemail or Text.

Licensed in the following States: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Georgia, Idaho, Louisiana, Michigan, Mississippi, Missouri, Montana, New Mexico, New York, North Carolina, Oklahoma, Texas, Washington, Wyoming.

J.M. Strange & Company -- Insurance * Bonds

Property Loss Notice