Property Damage Claim

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Preferred Communication

Address of the Property

Date of Loss

Date

Type of Property

What type of damage have you experienced? (Select all that apply)

Describe the cause of the damage (e.g., fire, hurricane, burst pipe):

Have you filed an insurance claim?

Was your claim denied, delayed, or underpaid?

Have you consulted with another attorney?

Upload any supporting documents related to your claim:(e.g., insurance policy, denial letter, photos of damage, repair estimates, receipts)

Insurance company / carrier

Insurance policy number

Insurance claim number

List any lawsuit, court papers, hearing dates, or other urgent deadlines related to this claim

List any other attorneys, public adjusters, contractors, insurers, or parties involved

Submitting this form does not create an attorney-client relationship and does not mean Murr Law has agreed to represent you. Do not rely on this submission to protect a deadline. Preserve all policy documents, carrier correspondence, photographs, estimates, court papers, and notices. For a known urgent deadline, call 713-966-6140 and seek other counsel if needed.

State where the property is located

Is a public adjuster involved?

Additional client or co-owner full legal name (if any)

Public adjuster name and company (if applicable)

Public adjuster fee percentage in the contract (if known)

Upload the public adjuster contract (if applicable)