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D.B. of Shrewsbury saved $263.00

M.Z. of Westboro saved $355.00

D.G. of Spencer saved $292.00

S.C. of Worcester saved $488.00

W.G. of Framingham saved $113.00

C.A. of Shrewsbury saved $250.00

C.B. of Wellesley saved $491.00

D.S. of Southbridge saved $354.00

S.P. of Worcester saved $209.00

C.D. of Worcester saved $472.00

B.M. of Belmont saved $175.00

S.L. of Worcester saved $382.00

A.C. of Dudley saved 231.00

M.S. of Holden saved $195.00

 

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 Property Loss Notice
Form: Property Loss Notice
Property Loss Notice




Contact Information
Your Full Name:
(as listed on policy now)
Your Email Address:
Daytime Telephone Number:
Description of Loss
Time & Date of Loss:
 Time AM PM
Date
Location:


Description of Loss:
Police or Fire Department:
Notified?
 Yes No
If Yes, Please Specify:

Is Property Habitable?:
 Yes No
If No, Where Are You Staying:
or Planning to Stay?
(Please include Address &
Telephone #'s you can be reached at):
Mortgagee or Bank Information

Please Note: Submitting this form via the website does not constitute a "formal" claim. Please contact us or your insurance company to notify of a loss.

Enter the security code you see above. Code is NOT case sensitive.*
 
 
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