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The general purpose for our Claims Documentation Form is to provide you with an easy to use method of supplying the claims process with a written description of exactly what happened, in your own words.

Providing this information does NOT replace the need for a claims adjuster to personally contact you.  It does however allow you to document, in great detail, what has occurred for your file and records within our office.

Please remember to: Always call first to report your claim.

Online Claims Documentation/Information Submission
CondoInsuranceNow.com

Please Provide Your Information

*Your Full Name:
*E-mail Address:
Day Phone:
Evening Phone:
Would you like us to contact you concerning the information contained in this form:
If you answered "YES" to the previous question what is your preferred Method Of Contact:

 

Insurance Policy Information

Insurance Company Name:
Your Policy #:
Have you already spoken with the Insurance Company about your Claim:
If the Insurance Company issued you a Claim #, can you inform us of what it is:

 

Incident Information

Claim Type:
Date Of Incident: mm/dd/yy

 

Please Provide Any Witness Names, Telephone Numbers, Etc.
(If Applicable)

 

Incident Description
Please be as specific in detail as you wish.

Click "Submit Form" to send your completed information.

 

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CondoInsuranceNow.com
A Division of Baer Insurance Services, LLC.
9701 Brader Way, Madison WI 53593
Tel: (608) 664-2237 • Fax: (608) 664-2233
Toll Free: (888) 729-2237
Email: info@CondoInsuranceNow.com

 

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Please Note: The information contained in this Web site is provided solely as a source of general  information and resource.  It is a not a statement of contract and coverage may not apply in all areas or circumstances.  For a complete description of coverages, always read the insurance policy, including all endorsements.
Licensed in the following states: WI, IL, MN, IA