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George Butler Adjusters
Claims handling excellence in Massachusetts, Connecticut and Rhode Island
Claims Handling
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Submit a Claim
What We Do
Who We Are
Claims Handling
Contact Us
Forms
Guidelines
Home
Service Areas
Submit a Claim
What We Do
Who We Are
Submit a Claim
We thank you for the assignment. If this loss is submitted during normal business hours you should receive electronic notification within 24 hours.
Claims Submission Form
Insurance Company
*
Contact at Insurance Company
Email
*
Phone
*
Fax
Claim Number
Policy Number
*
Policy Type
Type of Loss
Date of Loss
*
MM slash DD slash YYYY
Loss Location
Insured's Name
*
Insured's Phone Number
*
Insured's Mailing Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Claimant's Name
First
Last
Claimant's Mailing Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Description of Loss:
Upload Files
Drop files here or
Select files
Accepted file types: jpg, png, pdf, doc, Max. file size: 128 MB.
You may use this section to upload any files or documents. Allowed file types: jpg, png, pdf Maximum file size 128MB
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