ASSIGN A CASE

For more information fill this this form and we will contact you within the next 48 hours.

Assignment Client

Name *

First

Last

Email *

Client Claim Number *

Phone Number *

Client Type *

Category *

Client Rep Details

Name *

First

Last

Email *

Phone Number *

FAX Number *

Claimant Details

Claimant Name *

First

Last

Claimant Email *

Claimant Phone Number *

DOB (mm/dd/yyy) *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Claimant Vehicle

make and model *

OWNER *

operator *

damage estimate *

license plate or VIN# *

Claimant Insurance Carrier

Insurance Carrier *

Insurance Contact No. *

Insurance Policy No. *

Phone Number *

Insured Details

Name *

First

Last

Email *

Phone Number *

Insured DOB (mm/dd/yyyy) *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Assignment Loss Details

Loss Location *

Date of Loss (mm/dd/yyyy) *

Additional Info *

Description of Loss *

Submit

Submit Docs

James and his team really made a difference in the outcome of my case. We could have had a much more significant loss without the Claims Advantage!

ASSIGN A CASE

For more information fill this this form and we will contact you within the next 48 hours.

Assignment Client

Client Rep Details

Claimant Details

Claimant Vehicle

Claimant Insurance Carrier

Insured Details

Assignment Loss Details

Claims Advantage, Inc. Is committed to excellence in completing thorough investigations, and providing timely and comprehensive results with proven excellence.

Contacts

jbarbieri@claimsadvantage.com

ASSIGN A CASE

For more information fill this this form and we will contact you within the next 48 hours.

​Assignment Client

Client Rep Details

Claimant Details

Claimant Vehicle

Claimant Insurance Carrier

Insured Details

Assignment Loss Details

Claims Advantage, Inc. Is committed to excellence in completing thorough investigations, and providing timely and comprehensive results with proven excellence.

Contactsjbarbieri@claimsadvantage.com

Assignment Client

Contacts

jbarbieri@claimsadvantage.com