10/15/2008 03:49:46 PM



192 Worcester Street (Rt 9) | Wellesley Hills, MA 02481 | Tel. (800) 696-2901 | Fax 781-237-3069
Mass Auto Insurance
Request a quote on-line for Massachusetts Auto Insurance.
Homeowners Insurance
We offer competitive homeowners insurance programs.
Life Insurance
Personal Life Insurance Programs.
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Report Property Loss
For faster service on your claim report your loss directly to your insurance carrier at the numbers below.

Commerce Insurance customers call 1-800-221-1605
Fireman's Fund Customers call 1-800-647-7011

 


Property Loss Notice

 General Information
 Name  
 Email    
 Street Address  
 Street Address  
 City, State, Zip  
 Phone Number(s)   Home Work
 Email  
 Policy Number  
 Insured Name, if different  
 Loss Details
 Date of loss  
 Location of loss  
 Type of loss  
 Estimated total value of loss  
 Reported to Police or Fire Dept?  
      If yes, name of Dept  
      If yes, report number  
 Description of loss and/or damage

 

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