PUBLIC ADJUSTERS
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Residential Estimating Assignment
Assigner Info Attorney or PA Handling File
*
Indicates required field
Name of Company Making Assignment
*
Name of Person Making Assignment
*
First
Last
[object Object]
Email of Person Making Assignment
*
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 / Areas Affected
*
Explain the Loss and Areas Affected. Ex: Supply Line Leak in Hall Bathroom or Drain Line Leak under Slab in Kitchen...
Areas / Coverages to Inspect & Estimate
RESIDENTIAL - Select Lines of Coverage to Include
*
Dwelling Estimate
Other Structures Estimate
Contents Inventory
ALE Assessment / Estimate
Mold Remediation Estimate
Place a check mark beside all lines of coverage that the Assigner would like Inspected & included in the Estimate. For a FULL INSPECTION, including the entire property (dwelling, sheds, fences, and an assessment of damaged contents) check all lines of Coverage. Applicable Fees may apply to assignments with Contents Assessments.
Supporting Document Upload (
Policy Declarations Required
)
Upload Policy Declarations or Policy
*
Max file size: 20MB
Assigner can upload claim specific documents, such as Policy Declarations, EMS, GC Bids, Photos from Insured, Engineering Reports, Carrier Estimates, Etc.
Upload File
*
Max file size: 20MB
Assigner can upload claim specific documents, such as Policy Declarations, EMS, GC Bids, Photos from Insured, Engineering Reports, Carrier Estimates, Etc.
Upload File
*
Max file size: 20MB
Assigner can upload claim specific documents, such as Policy Declarations, EMS, GC Bids, Photos from Insured, Engineering Reports, Carrier Estimates, Etc.
Upload File
*
Max file size: 20MB
Assigner can upload claim specific documents, such as Policy Declarations, EMS, GC Bids, Photos from Insured, Engineering Reports, Carrier Estimates, Etc.
Upload File
*
Max file size: 20MB
Assigner can upload claim specific documents, such as Policy Declarations, EMS, GC Bids, Photos from Insured, Engineering Reports, Carrier Estimates, Etc.
Upload File
*
Max file size: 20MB
Assigner can upload claim specific documents, such as Policy Declarations, EMS, GC Bids, Photos from Insured, Engineering Reports, Carrier Estimates, Etc.
Assignment Specific Task Notes:
*
Assigner can indicate specific details pertaining to this loss and assignment. i.e. Areas of the Property that were Damaged, Gate Code for Community, Etc.
SUBMIT RESIDENTIAL ESTIMATING ASSIGNMENT TO TOTAL CLAIMS
Home
Claim Types
Cast-Iron
Water Damage / Plumbing Claims
Fire & Smoke Claims
Hurricane Claims
Roof Leak Claims
Hail Claims
Lightning Claims
Earthquake Claims
Theft
Sinkholes
Business Interruption
Appraisal Services
Estimating Services
Drone Services
Free Consultation
About TCI
Contact
Tracking the Tropics
National Hurricane Center
Mike's Weather Page