Add New Assignment
Claim Information
Insurance Company
Adjuster
First Name
Last Name
Phone
Email Address
Insurance
Company Name
Policy Number
Date of Loss
-
Month
-
Day
Year
Date
Deductible Amount
Assignment Type
Please Select
Auto
Estimate Review
Heavy Equipment
Property Damage
Desk Review
Diminished Value
Other
Exotic
Catastrophe
Motorcycle
Recreational
Warranty Claim
Subrogation
Claim for
Please Select
Insured
Claimant
Type of Loss
Please Select
Collision
Comprehensive
Hit and Run
Theft
Vandalism
Liability
Property-Residental / Commercial
Hail
Flood
Fire
Glass Claim
Windshield Cliam
Repo
Borrower
Other
Claim Information
Policy Number #
Stock Number #
Deductible Amount
Date of Loss
-
Month
-
Day
Year
Date
Type of Loss
Comprehensive
Liability
Collision
Vehicle or Property Type
Auto
Specialty Auto
Antique/Classic Auto
Light Duty Commercial
Truck/Tractor Trailer
Trailer Commercial
Tow Truck
Emergency Vehicle
Limousine
Bus
Farm/Agriculture
Construction Equipment
Crane
Recreational Vehicle
Marine/Boat
Motorcycle/ATV/Snowmobile
Custom Motorcycle
Residential/Commercial Structure
Cargo
Insured/Claimant
This assignment is for:
Insured
Claimant
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Email
*
example@example.com
Damage:
Facts of Loss / Assignment Instructions
Vehicle
Year
Model
License Plate
Make
VIN
Color
Location
Type
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
-
Area Code
Phone Number
Assignment
Assignment Type
Field Appraisals
Supplement
Photos Only
Correction
Recorded Statement
Police/Fire Report or DOC's
ACV-Market Valuation
DOI Reinspection-Auto
Subrogation Review-Auto
Subrogation-Review Heavy Equipment/Specialty
Salvage Bids
Scene Investigation
Task All Other
Desk Review
DOI Reinspection-HE
Appraisals CAT
Diminished
Value-Auto
Diminished Value-Heavy Equipment
DRP Reinspection
CPI Inspections
Cause & Origins
Assignment Sheet Files
Browse Files
Cancel
of
Completed Files Delivery and Status Notifications
Deliver File Completed to Owner/Shop
Yes
No
Deliver Files to Additional Insurance Company Email Addresses
Deliver Files to Fax
Status Notifications Email Address
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