Insured Loss Information for Great Lakes Policies
Date of Loss
Insured's Name
Contact Number
Contact Email
Insured's Policy Number (If unknown, need carrier name)
Contact Person, if other than insured
Alt email/number
Location of Loss
Loss Description
Characterize Loss
Please select...
· Severe (building destroyed/major structural damage; anything rendering the building unsafe or unusable)
· Moderate (roof damaged but generally remains functional/multiple leaks and trees on property, but building remains usable and/or livable).
· Minor - missing shingles/minor leaks or damage/damage to small other structures/fences, etc.
Loss Details
Further Remarks. Anything they tell you may be helpful.
Contact Information
Insured Loss Information for Great Lakes Policies
Insured Loss Information for Great Lakes Policies