Tanner, Ballew and Malloof, Inc.

Report a Property Claim

Please provide as many details as possible in order to avoid delay in reporting this claim to your insurance carrier.  All fields indicated with an asterik (*) must be completed.
Submitted By*: First Name:   Last Name:
Company:
Location Code:
Email Address*:
Telephone Number:
Date of Loss: Time of Loss: AM PM
Location of Loss:
Description of Loss:
On-site Contact Person: Telephone Number:
PROPERTY DAMAGE CLAIM
Have repairs been started? Yes    No By Whom?
Total Amount of Loss: Police/Fire Dept Responding:
BUSINESS INTERRUPTION CLAIM
Hours Closed: Why closed?
CRIME  CLAIM
Total Amount of Loss: Police Dept Responding:
OTHER PARTY RESPONSIBLE FOR LOSS
Party (including address & telephone):
ADDITIONAL INFORMATION:
To submit your claim, please click the "Submit" button.
A confirmation will be sent to you by email.