Insured Name(s):

You are the:

Your title:

Company Name:

Mailing Address:

Cell Phone:

Other Phone:

Email Address:

Who is the Named Insured on the Policy:

Insurance Company Name:

Insurance Agent Name & Address:

Mortgage/Lienholder Name & Loan Number :

Mortgage/Lienholder Address:

Insurance Policy Number:

Date Policy Expires:

Address of the Property Loss:

Date Damage Discovered:

Date of Loss (DOL):

Date Damage Reported to Insurer:

Claim Number:

Type of Loss:
WindHailFloodFireHurricaneOther

Description of Damage:

Type of Property:
ResidentialCommercialIndustrial

Insurance Adjuster Name & Phone:

Is an attorney or public adjuster already engaged?:
NoYes

If Yes, Adjuster's Name:

DOCUMENTS NEEDED FOR CLAIM FILE:

  • Signed PA Agreement scanned and emailed to Suncoast Claims Inc.
  • Signed Notice of Representation, scanned and emailed to Suncoast

Scan & email or fax these signed documents to us. Afterwards MAIL or FEDEX the ORIGINALS.

Next, we will immediately need the following items scanned and sent by attachment to email. If mailed or FEDEX, PLEASE SEND COPIES – DO NOT SEND ORIGINALS:

  • Copy of your Declaration Pages from your policy
  • Copy of your Policy that was in place on the loss date
  • Claim Acknowledgement letter from your Insurer
  • Copy of correspondence (letters, emails) from your carrier and adjuster
  • Copy of all estimates and engineer reports you received
  • Carrier Proof of Loss (POL) blank form if one was sent to you
  • Copy of executed POL if already sent to the carrier
  • Claim damage pictures you have taken (digital) (before and after)
  • Contents inventory if applicable – contact us for instructions
  • Provide a Copy of any Maintenance Records, Repair Invoices, Extra Expenses
  • Copy of Contractor Proposals for Repair
  • Copy of Engineer Reports either prior to or after the loss
  • Copy of any Contractors Contracts, Bids, or Agreements