Full assignment

Photos required

Appraise collision

Appraise property damage

Secure official reports

Scene Investigation

Secure recorded statements

Evaluate bodily injury/business interruption

Cause & origin investigation

Obtain expert

PILR

Ins. to value worksheet

Company Assigning Claim
Name (required):

Email (required):

Company Assigning Claim:

Phone Number:

Claim Number:

Insured:

Policy Number:

Date of Loss:

Insured's Address:

Insured's Telephone:

Claimant's Name and Address:

Claimant's Telephone:

Loss Location:        Closest N.C. city -- >        _Select a city Aberdeen Ahoskie Alamance Albemarle Alexander Mills Alliance Andrews Angier Ansonville Apex Arapahoe Archdale Arlington Asheboro Asheville Askewville Atkinson Atlantic Beach Aulander Aurora Autryville Ayden Badin Bailey Bakersville Banner Elk Bath Bayboro Bear Grass Beaufort Beech Mountain Belhaven Bellwood Belmont Belville Benson Bessemer City Bethania Bethel Beulaville Biltmore Forest Biscoe Black Creek Black Mountain Bladenboro Blowing Rock Boiling Spring Lakes Boiling Springs Bolivia Bolton Boone Boonville Bostic Brevard Bridgeton Broadway Brookford Brunswick Bryson City Bunn Burgaw Burlington Burnsville Calabash Calypso Cameron Candor Canton Cape Carteret Carolina Beach Carrboro Carthage Cary Casar Castalia Caswell Beach Catawba Cedar Point Centerville Cerro Gordo Chadbourn Chapel Hill Charlotte Cherryville Chimney Rock Village China Grove Chocowinity Claremont Clarkton Clayton Clemmons Cleveland Clinton Clyde Coats Cofield Colerain Columbia Columbus Como Concord Conetoe Connelly Springs Conover Conway Cooleemee Cornelius Cove City Cramerton Creedmoor Creswell Crossnore Dallas Danbury Davidson Denton Dillsboro Dobbins Heights Dobson Dortches Dover Drexel Dublin Dunn Durham Earl East Arcadia East Bend East Laurinburg East Spencer Eden Edenton Elizabeth City Elizabethtown Elk Park Elkin Ellenboro Ellerbe Elm City Elon College Emerald Isle Enfield Erwin Eureka Everetts Fair Bluff Fairmont Faison Faith Falcon Falkland Fallston Farmville Fayetteville Fletcher Forest City Fountain Four Oaks Foxfire Village Franklin Franklinton Franklinville Fremont Fuquay-Varina Gamewell Garland Garner Garysburg Gaston Gastonia Gatesville Gibson Gibsonville Glen Alpine Godwin Gold Hill Gold Point Goldsboro Goldston Graham Grandfather Village Granite Falls Granite Quarry Green Level Greenevers Greensboro Greenville Grifton Grimesland Grover Halifax Hamilton Hamlet Harmony Harrells Harrellsville Harrisburg Hassell Havelock Haw River Hayesville Henderson Hendersonville Hertford Hickory High Point High Shoals Highlands Hildebran Hillsborough Hobgood Hoffman Holden Beach Holly Ridge Holly Springs Hookerton Hope Mills Hot Springs Hudson Huntersville Indian Beach Indian Trail Jackson Jacksonville Jamestown Jamesville Jefferson Jonesville Kannapolis Kelford Kenansville Kenly Kernersville Kill Devil Hills King Kings Mountain Kingstown Kinston Kittrell Kitty Hawk Knightdale Kure Beach La Grange Lake Lure Lake Park Lake Waccamaw Landis Lansing Lasker Lattimore Laurel Park Laurinburg Lawndale Lawsonville Leggett Leland Lenoir Lewiston-Woodville Lewisville Lexington Liberty Lilesville Lillington Lincolnton Linden Littleton Locust Long Beach Long View Louisburg Love Valley Lowell Lucama Lumber Bridge Lumberton Macclesfield Macon Madison Maggie Valley Magnolia Maiden Manteo Marietta Marion Mars Hill Marshall Marshville Matthews Maxton Mayodan Maysville Mcadenville Mcdonald Mcfarlan Mebane Mesic Micro Middleburg Middlesex Milton Minnesott Beach Mint Hill Mocksville Momeyer Monroe Montreat Mooresboro Mooresville Morehead City Morganton Morrisville Morven Mount Airy Mount Gilead Mount Holly Mount Olive Mount Pleasant Murfreesboro Murphy Nags Head Nashville Navassa New Bern New London Newland Newport Newton Newton Grove Norlina Norman North Topsail Beach North Wilkesboro Northwest Norwood Oak City Oakboro Ocean Isle Beach Old Fort Oriental Orrum Oxford Pantego Parkton Parmele Patterson Springs Peachland Pembroke Pikeville Pilot Mountain Pine Knoll Shores Pine Level Pinebluff Pinehurst Pine Hall Pinetops Pineville Pink Hill Pinnacle Pittsboro Plymouth Polkton Polkville Pollocksville Powellsville Princeton Princeville Proctorville Raeford Raleigh Ramseur Randleman Ranlo Raynham Red Oak Red Springs Reidsville Rennert Rhodhiss Rich Square Richfield Richlands River Bend Roanoke Rapids Robbins Robbinsville Robersonville Rockingham Rockwell Rocky Mount Rolesville Ronda Roper Rose Hill Roseboro Rosman Rowland Roxboro Roxobel Rural Hall Ruth Rutherford College Rutherfordton Saint Helena Saint Pauls Salemburg Salisbury Saluda Sandy Creek Sandyfield Sanford Santeetlah Saratoga Sawmills Scotland Neck Seaboard Seagrove Selma Seven Devils Seven Springs Severn Shallotte Sharpsburg Shelby Siler City Simpson Sims Smithfield Snow Hill Southern Pines Southern Shores Southport Sparta Speed Spencer Spencer Mountain Spindale Spring Hope Spring Lake Spruce Pine Staley Stallings Stanfield Stanley Stantonsburg Star Statesville Stedman Stem Stokesdale Stoneville Stonewall Stovall Sugar Mountain Sunset Beach Surf City Swansboro Sylva Tabor City Tar Heel Tarboro Taylorsville Taylortown Teachey Thomasville Tobaccoville Topsail Beach Trent Woods Trenton Troutman Troy Tryon Turkey Uninc. Valdese Vanceboro Vandemere Varnamtown Vass Waco Wade Wadesboro Wagram Wake Forest Wallace Walnut Cove Walnut Creek Walstonburg Warrenton Warsaw Washington Washington Park Watha Waxhaw Waynesville Weaverville Webster Weldon Wendell West Jefferson Whispering Pines Whitakers White Lake Whiteville Wilkesboro Williamston Wilmington Wilson Windsor Winfall Wingate Winston-Salem Winterville Winton Woodfin Woodland Wrightsville Beach Yadkinville Yanceyville Yaupon Beach Youngsville Zebulon
          OR SELECT         N.C. county --->        _Select a county Alamance Alexander Alleghany Anson Ashe Avery Beaufort Bertie Bladen Brunswick Buncombe Burke Cabarrus Caldwell Camden Carteret Caswell Catawba Chatham Cherokee Chowan Clay Cleveland Columbus Craven Cumberland Currituck Dare Davidson Davie Duplin Durham Edgecombe Forsyth Franklin Gaston Gates Graham Granville Greene Guilford Halifax Harnett Haywood Henderson Hertford Hoke Iredell Jackson Johnston Jones Lee Lenoir Lincoln Macon Madison Martin McDowell Mecklenburg Mitchell Montgomery Moore Nash New Hanover Northampton Onslow Orange Pamlico Pasquotank Pender Perquimans Person Pitt Polk Porquimans Randolph Richmond Robeson Rockingham Rowan Rutherford Sampson Scotland Stanly Stokes Surry Swain Transylvania Tyrrell Union Vance Wake Warren Washington Watauga Wayne Wilkes Wilson Yadkin Yancey
Loss Location (more detail if necessary):

Local Authorities (police, fire department, etc.):

Description of Loss:

Handling Instructions: