Assign a Case

The starting point for opening an investigation is to Assign a Case. This opens a new case for review.

Enter all of the relevant details for the case.
All items marked with an *asterisk must be filled out.
The more detail entered, the better the case can be researched.
New cases will be empty, but you will be able to view case notes and media as soon as it is collected.

Click on the compass at the right to go to the next page in the tour.

Please fill out all applicable information – however if you don’t have certain information we will find it for you. Please provide a new form for each claimant.

*Required Information

*Claim Number:
*Your Insured:
*Claimant/Subject:

*Date of Loss:

Date of Birth:
SSN:
Address:
City:
State:
Phone #:
Cell Phone #:
Work Phone #:
Injury:	This is where you would enter details of any injuries sustained during the incident that is under investigation.
IME Date:
IME Time:
IME Dr. Name:
IME Address:	9 Medical Dr. Nowhere, NO 01234
Vehicle Info & Registration No.:	This is where you would enter any details relating to an incident that involves a motor vehicle.
Employment:
Spouse's Name:
Claim Type:
Investigation Requested:

Additional Information: