File a Claim for Busienss Loss

 

Filling out this form does not replace a documented claim. It is used to help expediate your claim. Please contact your insurance agent to file a formal claim.

 

*Required fields

 

Contact Information
Your Name:* (As listed on your policy)
Phone Number:*
Email Address:
Description of Loss
Date of claim: (MM/DD/YEAR)*	Time:*	AM / PM:* AM   PM
Location:*
Type of accident/claim* Property   Liability   Automobile   Workers Comp   Other	If other:
Description of loss:*
Name(s) of injured parties:
Vehicle description: (Applicable to auto claims only)
Driver name: (Applicable to auto claims only)

 

 

 

 

 

You shouldn’t have to worry about your insurance, whether you’re over paying or what’s covered and what’s not. Our mission at Campbell Insurance Services, Inc. is to provide you with the right coverage to fit your individual lifestyle and budget.

Treating our clients problems as our own, we are committed to a high standard of customer service.

We work for you, not an insurance company.

“It’s my job to find our
customers the right coverage.
What’s the best for them.”

Alexis Chambers
Campbell Insurance Agent
alexis@campbellsinsurance.com