Report a Claim

If you would like to report a claim to us directly, please contact us at 800-475-8880, or you are welcome to complete the form below and submit it to our office. This form will only be viewed during our regular business hours. If you need immediate assistance call the carrier directly 24/7. Contact numbers for each carrier can be found on the carrier contact page.

Name of Insured * Phone Number * Email * Street Address

City

State

Zip

Insurance Company Policy Number Date and Time of Loss Location of Loss Kind of Loss Reported To (Fire Dept, Police Dept) Report Number Description of Loss Contact Person Contact Info (Phone or Email)

Fred Heipp Insurance Agency Inc

Report a Claim