Submit a Claim

To Submit a Claim, simply fill out the form below or email us at Claims@adjusterassist.com. We appreciate your buisness.

Adjuster Name

First Name

Last Name

Insurance Company

Claim Number

Insured Name

First Name

Last Name

Special Instructions

Would you like us to contact the contractor to request supporting documentation and negotiate the settlement amount

Do not Contact Contractor

Contact Contractor to get supporting documentation

Contact Contractor to get supporting documentation and negotiate settlement