REPORT a LOSS

To report a loss, please either call 866.918.RELO (7356), or fill out the form below. We operate 24/7 and will contact the family within 15 minutes of being contacted by you.

 

	Adjuster Information		Policyholder Information
	Your Name:	Required	Policyholder Name(s):	Required
	Company:	Required	Phone Number:	Required
	Phone Number:	Required	Loss Address:	Required
	Claim Number:	Required	City:	Required
			State:	Required
	Type of Relocation		Number of Adults Affected:	Required
	Instant Lodging Hotel Temporary Housing Select at least one.		Number of Children Affected:	Required
			Number of Bedrooms Needed:	Required
	Additional Comments:		Lease Length:	--please select one-- Hotel Only 1-4 Months 5+ Months Please select an item.