Select your claim type

Not sure which form to use? Each claim type serves a different need. Review the options below to find the right one for your situation.

Insured Claim Submission

For policyholders reporting a new claim directly. Have your policy number and loss details ready before starting.

  • Report your claim directly
  • Upload supporting documents
  • Provide loss description and photos
  • Available in English and Spanish
  • Receive Confirmation upon submission
  • Track your claim status with your agent

New Claim Assignment

For insurance carriers and agents submitting a new property damage or liability claim for investigation and adjustment.

  • Property or Liability assignment
  • Loss investigation and documentation
  • Coverage analysis and reporting
  • Policyholder communication
  • Photo and evidence collection
  • Detailed loss report delivery

New Claim Assignment

Claim Reporter Contact Information

Insured Information

Claimant Information

Claim Assignment Details

Claim Information

Max file size 10MB.
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Thank you for your submission. Our team has been notified and will review your claim shortly.
Oops! Something went wrong while submitting the form.
If your documents are larger than 20MB, please email them to: NewClaims@millsmehr.com

Insured Claim Submission

Insured Contact Information | Información de Contacto del Asegurado

Agent Contact Information | Información de Contacto del Agente de Seguros

Claim Information | Información del Reclamo

Upload a copy of the policy, declaration page, &/or additional documents to help expedite the claim intake process. (Limited to 3 files, 10MB each)
Suba la copia de la Póliza, Página de la Declaración, y/o cualquier documento adicional que ayude a agilizar el proceso de admisión (Limitado a 3 documentos que no excedan 10MB cada uno)
Max file size 10MB.
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Max file size 10MB.
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Max file size 10MB.
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Thank you for your submission. Our team has been notified and will review your claim shortly.
Oops! Something went wrong while submitting the form.
If your documents are larger than 20MB, please email them to: NewClaims@millsmehr.com

Email Us Directly

If you already have your loss notice and/or claim documents ready, you can email them directly to us at our general mailbox:

Have a rush claim?

Need to rush a claim but missing some loss info? Call us and we'll get it assigned right away. 727.669.0140

Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.

Claim Reporter Contact Information

Insured Information

Claimant Information

Claim Assignment Details

Claim Information

Max file size 10MB.
Uploading...
fileuploaded.jpg
Upload failed. Max size for files is 10 MB.
Max file size 10MB.
Uploading...
fileuploaded.jpg
Upload failed. Max size for files is 10 MB.
Max file size 10MB.
Uploading...
fileuploaded.jpg
Upload failed. Max size for files is 10 MB.
Thank you for your submission. Our team has been notified and will review your claim shortly.
Oops! Something went wrong while submitting the form.
If your documents are larger than 20MB, please email them to: NewClaims@millsmehr.com