Keller-Lowry Insurance, Inc. Serving Colorado's Insurance Needs Since 1972
 
Keller-Lowry Insurance, Inc.

1777 S. Harrison Street, Suite 700
Denver, Colorado 80210

Phone:
Toll Free:
Fax:
  (303)756-9909
(800)753-9909
(303)756-8818

 
 
 
Trusted Choice

 
Property Loss Notice

Please use the form below to notify us of any loss or damage to your property insured through this company/agency. Please note that this form is for notification purposes only and does not constitute making an actual claim. One of our representatives will contact you shortly after receiving this notification.

Disclaimer
I understand that this does not constitute an actual claim, but is rather a notification to my agent of an existing loss or claim, and may help expedite the claim process once I have filed.

 I have read and agree with the above disclaimer.
  (Box must be checked before request can be sent)

Select Account Representative
Please select your account representative,
or leave as "General Representative"
if you do not have one:

Policy Holder Information
Please be sure to supply your phone number and email address
so that we may contact you after receiving this notification.
Name Insured:
Address:
Phone #: Work     Home
Email:

Time and Description of Loss
Time & Date of Loss
Time a.m.
p.m.
    Date
Location of Property:
Description of Loss:

Authority Notification
Were the Police or Fire Dept. Called? Yes     No
If Yes, which Authority?

Property Status
Is the Property habitable? Yes     No
If No, where are you staying: (Address and Telephone)

Report Information
Reported by:
Title (if any):
Date:


Additional Comments
Please give any additional comments you feel appropriate for this Loss Notice.


Please click on the "Submit Form" button to send your Loss Notice.
One of our representatives will respond to your submission as soon as possible.

   

Online Forms by ENHANCED Web Services
This Property Loss Notice Form Copyright © 1998 - by ENHANCED Web Services

 

Home   |   About Us   |   Newsletters   |   Pledge of Performance   |   Privacy Statement

Insurance Glossary   |   Industry Links   |   Contact Us   |   Commercial Insurance   |   Personal Insurance

Group Benefits Insurance   |   Programs   |   Customer Service   |   Risk Management Services

© Copyright Keller-Lowry Insurance, Inc., All Rights Reserved     |     Website Design by Enhanced Web Services