Submit a Claim

Submit a Claim

Submit a Claim

Please fill out the form below with the necessary claim information, so we may
provide you with immediate assistance.  One of our inventory specialist will be in contact with you as soon as possible to address any concerns.

This form will allow Content Solutions Inc., to determine the services necessary in order to complete the claim efficiently and effectively.

Insured’s Contact Information
Insured:
Contact Name:
Address 1:
City:
Address 2:
State:
Zip:
Phone Number:
(xxx-xxx-xxxx)
E-mail:
Cell Number:
(xxx-xxx-xxxx)
Fax Number:
(xxx-xxx-xxxx)
Alternate Contact
Alt Contact:
E-mail:
Alt Phone:
(xxx-xxx-xxxx)
Alt Cell:
(xxx-xxx-xxxx)
Adjuster’s Contact Information
Please check the box that applies: Independent Adjuster:   Insurance Company Adjuster:
Adjuster:
Title:
Company:
City:
Address 1:
State:
Address 2:
Zip:
Phone Number:
(xxx-xxx-xxxx)
Fax Number:
(xxx-xxx-xxxx)
Cell Number:
(xxx-xxx-xxxx)
E-mail:
Loss Information
Insurance Company:
Claim #:
Date of Loss:
Type of Loss, i.e. Fire, Flood, etc.:
Personal Property Loss
Commercial Loss
Description of the Stock:
 

Policy Limits:
Co-Insurance
(If Applicable):
Public Adjuster (If Applicable)
Contact:
Company Name:
Phone Number:
(xxx-xxx-xxxx)
Fax Number:
(xxx-xxx-xxxx)
Cell Number:
(xxx-xxx-xxxx)
E-mail:
Special Instructions:
Full Content Adjustment Scope of Contents Only Audit Inventory
Other