Flood Loss Claim Report

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Use this form if:


We’re here to help you every step of the way.

Some items not covered through your Flood policy may include:

  • Wind damage
  • Broken or frozen pipes
  • Appliance leak
  • Roof damage
  • Water Backup/Sewer Backup

These items may be covered by your homeowners policy, and you will need to file a separate claim for these types of water damages. Water damage to a vehicle should be filed as a separate auto claim. You can report a homeowner or auto claim on My Account.


Indicates required information(*).

Your Information:

Name of Primary Policyholder *
Primary Mailing Address *
City *
State *
Zip *
Primary Phone # * Ext
Secondary Phone # Ext
Policy Number  
Email Address *
Can we email you your claim number?
Language Preference

Other Language Preference
Street or Physical Address of Damaged Property *
City *
State *
Zip *
When did water enter your home?
Month *
Day *
Year *
Time *
Please give a brief description of damage *
What is the source of the water? *
Answer to the best of your ability.
How deep is/was the water? * Your best estimate.
How long was the water in your home? * Your best estimate from when the water entered your home.


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