Report a
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Claim

Tell us what happened

Please submit your claim using the form below. By completing this form you agree to our privacy policy.

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Report a Property Claim

"*" indicates required fields

1. Your information

First name*

Last name*

Relationship to claimant*

Employer*

Phone number*

Email*

2. Policy information

Policy number*

Company name*

Parent company name (optional)

3. Company address

Address line 1*

Address line 2 (optional)

City*

State

Zip code*

4. Address where loss occurred

Address line 1*

Address line 2 (optional)

City*

State

Zip code*

5. Claim description

Date of loss*

Time of loss*

Describe what happened and how it happened*

Describe the extent of the property damage*

Describe who was involved and any witnesses*

6. Other insurance

Other Insurance*

I agree to report my claim to other applicable insurance carriers *

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If you experience difficulties submitting your claim, please contact us at firstnotice@icwgroup.com or 1.877.442.9669 and select option #3.

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Report a
Property
Claim

Tell us what happened