Submit a Claim

We are sorry that you are experiencing a loss. Please complete the form below to submit a new claim to our Claims Department.

Policyholder Information

First Name of Policy Holder *

Last Name of Policy Holder

Email Address *

Phone Number *

Street Address *

Street Address Line 2

City *

Region / State / Province *

Postal / Zip Code *

Policy Number *

Date of Loss *

Loss Location *

Cause of Loss

Description of Loss and Damages *

Is the home livable?

YesNo

Is mitigation needed?

YesNo

If someone other than the policyholder completed this form, please provide contact information below:

First Name

Last Name

Email Address

Phone Number

Thank you. Your claim has been submitted to our Claims Department. A claims representative will contact you as soon as possible.

Something went wrong while submitting your claim. Please try again, or call us at (866) 228-7993.