Silas Chapman & Company - Insurance Since 1872. Serving West Hartford, Connecticut and the surrounding communities for over 135 years. 779 Farmington Avenue
2nd Floor
West Harford, CT  06119
Phone: 860.570.0700

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Insurance Claim Starter
 

Welcome to the property and Casualty Claim Starter form. Please follow the instructions to complete the necessary information on-line. When you are finished the form will be forwarded to the claim department. A claim service representative will contact you to discuss the details and explain the claim process.

* Required Field
1. Claim Information
Is this a personal or a business claim?

Please select the type of claim.





Other, explain:
Are you insured with Silas Chapman and Company?
2. Personal Information
Name*:
Address*:
City*:
State*:
Zip Code*:
Phone Number*:
(xxx-xxx-xxxx)
Email Address:
Best to Contact Via*:
When to Contact*:
3. Additional Information
Date of Loss*:
Location of Loss (City/State)*:
Reported to Authorities?*:
Loss Description*:
Damage Description:
Injury Description:
4. Additional Comments
 
Copyright 2009-2014 Silas Chapman & Company - All Rights Reserved.
Silas Chapman & Company • 779 Farmington Avenue • West Hartford, Connecticut 06119
Phone: 860.570.0700 Fax: 203.397.9497
  Website Design: QuesTronix Software
Silas Chapman & Company has been providing insurance to businesses and individuals
in West Hartford, Connecticut and the surrounding communities for over 135 years.
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