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New Assignment
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New Assignment
Please complete the applicable fields below and we will confirm the assignment with you shortly.
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Date
MM slash DD slash YYYY
Insurance Company
*
Is this a rush assignment?
Yes
No
Email
*
Enter Email
Confirm Email
Claims Adjuster
Name
Email
Phone
Defense Attorney
Name
Law Office
Email
Phone
Person Making Assignment (if different than above)
Name
Email
Phone
Claim Information
Claim #
*
File #
Signed Documents Needed?
Yes
No
Policy Number
*
Policy Limits
*
Notary Required
Yes
No
Date of Loss
*
MM slash DD slash YYYY
Case Name – if in litigation
Named Insured
*
Defendant
Facts of Loss – Type of Loss
*
Additional Information (please note if any fatalities or serious injuries involved)
Assignment Instructions
Recorded Statements(s)
Recorded Statement(s)
From who?
Signed Documents
Obtain Signed Documents
From who?
Notarized Documents
Obtain Notarized Documents
From who?
Contact Information
Locate an Individual and Obtain Contact Information
From who?
Location
Location Search / Skip Trace
For who?
Vehicle Photographs
Vehicle Photographs
Scene Photographs
Scene Photographs
Scene Canvass
Scene Canvass
MSC / Mediation Attendance
MSC / Mediation Attendance
Small Claims Attendance
Small Claims Attendance
Trial Monitoring
Trial Monitoring
Subpoena Service
Subpoena Service
Other
Other
Explain
Involved Parties
Involved Party
Select
Insured Driver
Insured Passenger
Named Insured
Claimant Driver
Claimant Passenger
Claimant Owner
Witness
Other (describe)
Other (describe)
Name
Email
Phone
Address
Additional Contact Information (Work, Family, etc.)
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Remove Party
Vehicles / Property Involved
Vehicle / Property Type
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Insured Vehicle
Claimant Vehicle
Insured Property
Claimant Property
Other
Vehicle / Property Description
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