Information On Other Parties
Please use the following section for identifying additional parties to the loss, such as eye-witnesses, police officers, attorneys, etc. (Not Required).
and Coverage Details
Insured Name and
Claim Details &
Please provide as much information about the claim as possible.
Required fields are marked by the * symbol.
If you do not have the information for a required field, please enter "unknown"
Copyright © S&S Claims Service. I Toll-Free: 800.222.1027 I 704.947.7722 I Fax: 866.728.7588 I Solutions@SSClaims.com