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Claim Service Referral Form 

 

Trinidad Claims Service has a solid track record of integrating claim services based on client specific needs.

Like most similar resources, our comprehensive selection of claims services work well together or independently.

But our true strength centers around helping clients create measurable and sustainable outcomes.

We are ready to help.

Call us anytime at 888­-598-4501 to discuss specific claim needs. Or, feel free to utilize the referral form below to initiate claim assignments.

Other options:

Email assignment: assignments@trinidadclaims.com 

Or fax to: (888) 607-7582

Link to us Via Xactanalysis or Symbility Administrator!

Submit a new assignment now:

Please make sure you enter all required fields.

INSURED

Date of Loss (required)

Claim or Policy # (required)

First Name (required)

Last Name (required)

Phone (required)

Mobile

Email Address (required)

Address 1 (required)

Address 2 (required)

City (required)

State/Province (required)

Zip Code (required)

Loss Description
INSURANCE COMPANY CONTACT INFORMATION

Company Assigning Claim (required)

Contact Name (required)

Company Email (required)

Company Phone 1 (required)

Company Phone 2