Condo Claims Form

Please fill in all information on this form.

* Required fields

Association Name/ Name on Policy *

Management Company

Incident Address *

Street Address *

Address Line 2 *

City *

Postal / Zip Code *

State / Province / Region *

Country *

Property Manager First Name

Property Manager Last Name

Property Manager Email *

Property Manager Contact Phone Number

Additional Contact First Name

Additional Contact Last Name

Additional Contact Phone Number

Date of Loss *

Time of Loss

Type of Claim *

Was anyone injured? If yes, please answer the following three questions. *

Yes

First Name of Injured Party

Last Name of Injured Party

Phone Number of Injured Party

Did the Injured Party Go to the Hospital?

Yes

Was a Police Report Filed?

Yes

Details of Incident: *

Human or Robot

Quick Links

Locations

40 Calhoun Street
Suite 215
Charleston, SC 29401
Office: 843-723-4001
Fax: 843-723-2120

PO Box 1487
465 Spruce Street
Walterboro, SC 29488
Office: 843-549-7777
Fax: 843-549-7563

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