Loss Assessment Form

If you would like to contact our office immediately regarding your project or loss call 855-822-1966 or send an email.

Otherwise, please fill out the form below and you will be contacted about your request as soon as possible. Please provide as much information as possible to assist us in processing your claim. Fields marked with a * are required.

If you are experiencing technical difficulty while trying to submit your request, contact Julie Kost 317-547-5580 or click here to email her.

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