Specialists in RV Claims Adjusting

Voice: 877-774-5152 | Fax: 866-624-6700

Online Assignment Submission

You will receive an email confirmation after submitting your assignment. If one is not received please contact us immediately – 877-774-5152.

Adjuster Name * required

Adjuster Phone * required

Adjuster Email * required

Insurance Company

Claim Number * required

Insured First Name

Insured Last Name

Address

City

State

Zip Code

Phone

Mobile

Insured Email

Inspection Location
Insured Address (skip Inspection fields below if same as above) Shop Address Other

Shop or Location Name

Inspection Address

Inspection City

Inspection State

Inspection Zip

Vehicle Description

Year

Manufacturer

Make

Model

Horsepower

VIN * required

Type of Loss * required

Deductible * required

Statement of Damages * required