Property Claim Reporting Guide
Account Information
- Advise State in which loss occurred
- Provide Company Information if applicable
- Your Business name & address (include specific division if applicable and mailing address if different than above)
- Where specifically did loss occur (e.g., warehouse, stockroom, specific department, etc.)
Accident Information
- Date & time of loss
- Detailed description of loss
- Witnesses including specific information on where they were at time of accident, any relationship to involved parties and means of contact (address, phone #, best time and place)
- Authorities (ambulance, police, fire) include address, report # and any violations/citations that may have been issued
- If loss was caused by product defect, please provide product information
including:
- how was product being used
- manufacturer's name, make, model, size, style, serial # and/or product I.D.
- was there damage to or defect in the product
- where & when was product purchased or installed
- where & when can product be seen
Property Damage and Claim Information
Advise what property or extra expense is involved in the loss:
- Building (real property) including detailed description of damage and estimate of damage, if available
- Building owner's name, address, home and business phone
- Contents (personal property) including a detailed description of what was damaged
- Content owners name, address, home and business phone # (Note that there could be a combination of property owned by you and property owned by others)
- Business interruption including dates and times of interruption, as well as estimate of loss involved
Advise if there is any other insurance available covering this loss and if so, name, address and phone # of Insurance Company as well as item/items covered and any applicable policy and/or claim numbers
Account Contact Information
Best person (including time & place) to contact for more information
Additional comments and information
Telephone Worksheet (.pdf)