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Report a Property Claim 

Use the form below to report claims to our office. Claim reports will be submitted to your insurance company by our office the following business day.

If this is an emergency, after our office hours or during a weekend or holiday, please report your claim directly to your insurance company claim office:

Emergency Claim Reporting Numbers

Links to Insurance Company Websites

PROPERTY LOSS NOTICE

POLICY HOLDER INFORMATION

Please be sure to supply all if your contact information so we
may promptly contact you after receiving this notification.

Name Insured:
Address:
Phone #: Work     Home
Email:
TIME AND DESCRIPTION OF LOSS
Time & Date of Loss
Time a.m.
p.m.
    Date
Location of Property:
Description of Loss:
AUTHORITY NOTIFICATION

Were the Police or
Fire Dept. Called?

Yes     No
If Yes, which Authority?
PROPERTY STATUS
Is the Property habitable? Yes     No
If No, where are you staying,
so we may contact you
(Address and Telephone)
REPORT INFORMATION
Reported by:
Title (if any):
Date:
ADDITIONAL COMMENTS
Please provide and additional comments you feel appropriate for this Loss Notice.

DISCLAIMER:

I understand that by completing this form it does not constitute an actual
claim, but is rather a notification to my agent of an existing loss or claim,
and may help expedite the claim process once I have filed.

 One of our representatives will respond to your submission as soon as possible.

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Your Independent Insurance Agency of Choice

AGIS Insurance Center, Inc.
205 Bishops Way Suite 202
Brookfield, WI 53005
Phone: 262-641-9800
Email:AGIS.HOME@agisins.com

Hours of Operation:

Monday - Thursday  8:30am to 5:00 pm CST

Friday 8:30am to 4:00 pm (8:30am to 1:00pm Memorial day thru Labor Day)

Or by Appointment


 

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AGIS Insurance Center

205 Bishops Way Suite 202

Brookfield, WI 53005

262-641-9800

888-781-2220

(Located in Bishops Woods,

Abor Terrace II building)