Koram Insurance - Property Loss Notice

home

customer service

contact

site map

Korean

QUICK & EASY QUOTE FROM MAJOR CARRIERS

Property Loss Notice

Property Loss Notice

Contact Information

Your Full Name:
(as listed on policy now)

Your Email Address:

Daytime Phone:

Description of Loss:

Time & Date of Loss:

Time AM PM
Date

Location:

Description of Loss:

Police or Fire Department Notified?:

Yes No

If Yes, Please Specify:

Is Property Habitable?:

Yes No

If No, Where Are You Staying or Planning to Stay?:

(Please include Address & Telephone #'s you can be reached at):

Any Additional Information Not Requested Above:

Please Note: Submitting this form via the website does not constitute a "formal" claim. Please contact us or your insurance company to notify of a loss.

Enter the security code you see above. Code is NOT case sensitive. *

Koram Insurance Center, Inc.

Phone: (866) 368-5800
email: info@koraminsurance.com

Licensed in CA,NV,WA,OR,AZ,CO,IL,OH,

� Copyright 2006
IMPORTANT NOTE: descriptions of insurance coverage on this web site are for informational purposes only and may not apply, or be included on your policy. Please contact us to confirm coverage provided on your insurance policy or policies your are contemplating purchasing. Coverage may not apply in all states. For complete details of coverages, conditions, limits and losses not covered, be sure to read the policy, including all endorsements.
READ OUR PRIVACY STATEMENT

Powered & Designed By:
Insurance Web Designs
websites for insurance agents