Instruct Adjuster

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Appoint us to handle an insurance claim on your behalf.

Please complete this online instruction form and one of our adjusters will contact the insured within one hour of receiving the details.
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Instruct Adjuster

Insured
Contact Person *If not above
Your Status
Insured Address
Situation of Loss
Contact Number: Home
Contact Number: Work
Contact Number: Mobile
Claims Officer
Email
Policy Number
Claim Number
Policy Details
Excess Amount
Date of Loss
Description of Loss
Antispam Code
Antispam Code