Property Loss Incident Report
Overview
Claims in this category involve property and equipment that are insured for damage subject to certain exclusions within the insurance policy. Follow the instructions below when damage to property occurs.
Instructions
Complete the report form and submit it to McGriff Claims Central as soon after the incident as possible. Take immediate steps to minimize the damage, prevent further damage and/or secure the damage property. This may include temporary repairs where necessary, calling the local fire department, a glass company or contractor. Take photos showing what and how the property was damaged to show condition immediately after the loss. If you obtain an estimate from a contractor regarding repairs, make sure it is detailed enough for the adjuster to be able to compare the work to be done with the damages involved.If someone is responsible for the damage, obtain the at-fault party’s name and address. Secure the name and address of any witnesses.Report the loss to McGriff or the insurance carrier. Once the loss has been reported to the insurance carrier, an adjuster will be assigned, and you will be instructed on how to proceed.In the case of theft, burglary, or robbery, notify the local police department immediately. Obtain the investigating officer’s name and the incident report number. The insurance company will need this important information to order a police report.Prepare and maintain copies of records and receipts associated with the loss. List all items damaged or stolen with values of each also listed.Work with the adjuster to agree upon scope of work and cost prior to making any additional repairs.
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Company Details
Insured/Company Name
*
Report Date (mm/dd/yyyy)
/
Month
/
Day
Year
Date
Contact Name
*
Contact Phone Number
*
Please enter a valid phone number.
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Incident Details
Please select all that are applicable to this loss.
Witnesses are available
I have at-fault party(s) contact information
Date of Loss (mm/dd/yyyy)
*
/
Month
/
Day
Year
Date
Time of Loss
Hour Minutes
AM
PM
AM/PM Option
Street Address of Loss
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Specific Location of loss (i.e., kitchen, warehouse, storage room, etc.)
Please upload any photos/videos from the loss.
Browse Files
Drag and drop files here
Choose a file
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of
Responding police and/or Fire Department
Officer and Report #
Description of Incident/loss.
Damage to Property
Is the damage causing an interruption to the business?
Yes
No
Please explain how the business is being interrupted.
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At-Fault Party(s) Contact Information
Please provide contact information for the at-fault party.
Contact information
Name
*
Phone Number
*
Please enter a valid phone number.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are there any additional at-fault parties?
*
Yes
No
Please enter contact information for additional at-fault party.
Name
*
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Witness Information
Please provide details of other vehicles/drivers involved in this incident.
Witness #1
Witness #2
Witness #3
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Attestation
Name
*
This acts as a digital signature.
Date (mm/dd/yyyy)
/
Month
/
Day
Year
Date
Signature
Should be Empty: