C.A.T.S. Assign Loss

Loss Assignment

To assign a loss, please complete this form and then click the submit button or you can fax your assignment to 888-769-5639.

Assignments may also be e-mailed to dispatch@claimsadminservices.com as an attachment.

Attachment formats that will be accecpeted are .tif .pdf .jpeg .

Insurance Company Info:

(*indicates required field)

Company Name*
Address City* State* Zip*
Adjuster Name*
Adjuster Phone Number* Fax Number
Adjuster E-mail How would you like to recieve the completed file?*
Additional Comments

Claim Info:

Claim #*
Policy # Type of loss*
Vehicle owner is ?	Insured Claimant
Owner Name*
Address* City* State* Zip*
Phone #*
Deductible Type of assignment*
Special Appraiser Instructions

Vehicle Info:

Type of vehicle?
Year*
Make*
Model*
VIN*	If the VIN is "unknown" type UNK
Notes

Fee schedule applies to routine damage appraisals and total loss evaluations on cars, trucks and vans up to 1 ton and motorcycles in which labor times and part prices are available in industry accepted estimating manuals or electronic databases.

Repairable fire, flood or mechanical damage losses requiring extensive time or multiple inspections, are subject to Time & Expense billing. Altered, customized vehicles, trucks in excess of 1 ton, recreational vehicles and marine may be billed at the appropriate Time & Expense hourly rate.

Thank you!