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Back to Report a Claim

Property Claim Form

Before filling out the form below, read the following instructions.

Instructions To Insured

  1. Please note that the submission of this form to us does not of itself bind, initiate or alter any of the conditions of your insurance program. Confirmation of any material changes to your policies can only/will only be made through contact with a Bolton & Company representative.
  2. Protect property from further damage.
    • Cover if exposed to the elements.
    • Make repairs if reasonable and necessary to protect property from further damage.
    • Maintain record of all expenses incurred protecting the property.
    • Separate damaged from undamaged personal property, if possible.
  3. Take photos of damage preferably before you take protective action.
  4. Prepare inventory of personal property damage.
    • List quantity, description, actual cash value & amount of loss.
    • Attached bills, receipts and related documents.
  5. Retained damaged property until a claims adjuster approves disposal (unless a danger to
    safety).
    • The adjuster may need to inspect the property.
    • The insurance company may be able to salvage damaged property.
  6. Notify police in the case of a theft.
  7. Be prepared to provide additional documentation as requested by the adjuster.
  8. Expect to be contacted by the claims adjuster within 48 hours.
    • If the damage significantly effects your continuing operation, we will request the
      insurance company to expedite your claim.
    • Please let us know immediately if your circumstances change and this loss will have a
      greater effect on your business than originally anticipated.

    IF POTENTIAL BUSINESS INTERRUPTION CLAIM INVOLVED:
  9. Record all expenses incurred due solely to the loss.
    • Wages for employees involved in clean up or repair.
    • Overtime paid for employees to fulfill orders that would have been completed
      during normal hours if not for the loss.
    • Outside venders involved in clean up, repair, etc.
    • Leasing of temporary space until your facility is repaired.
    • Leasing or purchase of any items necessary to continue operations.
    • Etc.
  10. Record all expenses that you continued to incur dispute the necessary suspension of your operations.
    • Wages for employees who were sent home but still paid (may be covered for continued payroll).
    • Etc.
  11. Document any business lost due to the necessary suspension of your operations.
    • Canceled order
    • Order refused
    • Etc
  12. Complete financial records may be necessary to determine your lost income due to
    the loss.
    • Your accountant may be able to assist especially if your on-location financial
      information was destroyed due to the loss.
    • The insurance company may assign an accountant to determine the exact amount of your loss.


Fields marked with * are required fields.

Contact Information
Please provide us with your contact information.
* First Name:
* Last Name:
* Street Address:
* City:
* State/Province:
* Zip/Postal Code:
Country:
* Day Phone:
Evening Phone:
Fax:
* E-mail:
 
Information about the Loss
 
Date of Loss:
Type of Loss:

Fire  
Lightning
Flood  
Theft
Hail
Wind

Other (Please describe)

Police or Fire Dept to which reported:

Location of Loss:
Description of Loss:
Additional Comments:
 
Submit Claim

Please click on the "Submit Claim" button below to send us your claim.

 
 
   
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