Report a Claim

Many of the companies we represent have 24-hour reporting numbers. You may report your claim direct to the insurer by calling the numbers found here. If you would like to report a claim to us directly, please contact us at 312.729.5265, or you are welcome to complete the form below and submit it to our office.

* Name of Insured (required) :
* Insured Phone Number (required) :
* Insured Street Address (required) :
* Insured City (required) :
* Insured State (required) :
* Insured Zip (required) :
* Insured Company (required) :
* Policy Number (required) :
* Date and Time of Loss (required) :
* Location of Loss (required) :
* Kind of Loss (required) :
Reported To (Fire Dept, Policy Dept):
Report Number:
* Description of Loss (required) :
* Contact Person (required) :
* Contact Info (Phone or Email) (required) :