Appraisal Assignment

Assigner Info Attorney or PA Handling File

* Indicates required field

Name of Company Making Assignment *

Name of Person Making Assignment *

First

Last

Email of Person Making Assignment *

Appraiser Being Named *

Name of Attorney or PA Handling File *

First

Last

Phone Number of Attorney or PA *

Email of Attorney or PA *

Client / Insured Info

Client/Insured Name *

First

Last

Client/Insured Phone Number *

Second Client (Optional) *

First

Last

Second Phone Number (Optional) *

Loss Location

Loss Location / Address *

Line 1

Line 2

City

State

Zip Code

Country

Insurance Company / Claim Info

Insurance Company Name *

Policy # *

Claim # *

Type/Cause of Loss *

Date of Loss *

Description of Loss / Claim *

Insurance Company's Appraiser - Contact Info

Carrier's Appraiser's Name *

First

Last

Carrier's Appraiser's Email *

Carrier's Appraiser's Phone Number *

Coverages Involved in the Appraisal Process

RESIDENTIAL - Select Lines of Coverage to Include *

Supporting Document Upload (Policy Dec, Atty/PA Est & Carrier Est Required)

Upload Policy Declarations or Policy *

Max file size: 20MB

Upload Attorney or PA's Estimate *

Max file size: 20MB

Upload Carrier's Estimate *

Max file size: 20MB

Upload Atty/PA Engineering Report *

Max file size: 20MB

Upload File *

Max file size: 20MB

Upload Carrier's Engineering Report *

Max file size: 20MB

Upload File *

Max file size: 20MB

Upload EMS Docs *

Max file size: 20MB

Upload File *

Max file size: 20MB

Assignment Specific Task Notes: *

SUBMIT APPRAISAL ASSIGNMENT TO TOTAL CLAIMS