Submit a Claim

You can submit a claim online, by Email, and by Fax

Online Submission

Adjuster Information

Policy Holder Information

Policy Information

Applicable Limits

Add a limit

Authorization

Attach the Inventory

Enter Items Manually

I have another item

Email a Claim

Please click the button below to download the claim worksheet. Fill in as much detail as possible, save the document with your corresponding claim number and email it back to claims@replacementsource.com

download claim worksheet

Fax a Claim

Click the button below to access the fax cover sheet. Once you've completed the form, print it and attach a full list of the property you would like evaluated and fax it to 800-275-5957.

download fax cover sheet