Property Claim Form

Incident Details

Use this form to report vehicle accidents which you believe could reasonably result in a claim against you. Do not use for General Liability, Auto or Worker's Compensation claims.

When describing the incident, please use as much information as possible. For example:

  • For stolen items, were they secured? What kind of lock? Who has the keys or access? Supply a list, original cost, date of purchase.
  • For damaged personal property, give brand names, original cost, date of purchase, and where it can be seen. (This can be collected over time and provided to the adjuster once assigned.)
  • For damaged property, was the item removed from the scene or location? Was it stored for examination by the investigator? If so, where was it stored? (Do the necessary work to protect the property from further damage until told different by the adjuster, and keep any and all receipts.)