Commercial Property claims form

We work closely with our clients and their brokers to service claims efficiently and supportively. Clients will often turn first to their broker in the event of a claim, particularly for Lloyd's policies. If you have already contacted your broker, he or she will already be pursuing the claim on your behalf. If you have not, we invite you to complete the following brief form. We will ensure that your broker is informed of your communication.

Fields marked with an asterisk (*) are required.

Name of insured:

Please enter a valid value

Name of person completing this form:

Please enter a valid value

Phone number of person completing this form:

Please enter a valid value

Email address of person completing this form:

Please enter a valid email address

Contact at insured (if different from above):

Please enter a valid value

Phone number of contact (if different from above):

Please enter a valid value

Beazley policy number:

Please enter a valid value

Date of the occurence:

Please enter date

Location of the loss:

Please enter a valid value

Estimate of damages:

Please enter a valid value

Name of insured's broker:

Please enter a valid value

STATE REQUIRED FRAUD WARNINGS
ANY PERSON WHO, WITH INTENT TO DEFRAUD OR KNOWING THAT (S)HE IS FACILITATING A FRAUD AGAINST THE UNDERWRITER, SUBMITS AN APPLICATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT MAY BE GUILTY OF INSURANCE FRAUD.

View all state specific fraud warnings.

Please note: After clicking submit you will need to verify the information entered and click submit again to send your request.

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