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File a Claim for Property 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 loss: (MM/DD/YEAR)*


AM / PM:*


Description of loss:*

Was police or fire department notified*

Is the property liveable*

Please list other addresses or phone numbers where you can be reached:

Mortgage or bank information:






Our mission at Campbell Insurance is to help guide and educate our clients about insurance to help fit their individual needs. We are always striving for a higher standard of customer service.

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

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

Alexis Chambers

Campbell Insurance Services, Inc. | 416 West Main St. | McNabb, Illinois 61335 | Phone: 815-882-2122