Phoenix-Jade Rein LPIALicensed Public AdjusterTX Lic: #2504045 Home About Services Contact Claim Evaluation Form Request a Free Claims Evaluation Policy Holder's First and Last Name*Property Address, City, State and Zip Code*Policy Holder's Phone Number*Policy Holder's Email Address*Property Type*ResidentialBusinessApartmentCommercialCondominiumIndustrialOtherName of Property or Business*Date of Loss*Type of Loss*Fire and Smoke DamageWater DamageFlood DamageTornado DamageHurricane DamageWind DamageRoof DamageLighting DamageCollapseBusiness InterruptionTheft and VandalismMold DamageOtherCause of the damage(s)*Severity of Damage*Minimum (damage to isolated area or single room)Minor (damage to a portion of a structure)Severe (structure is uninhabitable)Catastrophic (structure has been demolished)Did you file a claim? If so, when?*Was your claim denied?*Name of Insurance Company*Insurance Company's Phone Number?*Policy Number*Claim Number*Adjuster's Name, Phone Number and Email Address*Was a field adjuster sent out by your insurer? If so, when?*Have you received an estimated cost(s) of damage(s) from your insurer?**Has payment been made on any part of the claim?*Was damage that caused loss repaired/mitigated?*Name, address and phone number of repair/mitigation company?*Has contractor estimates been provided? List contractor information*This site uses Google reCAPTCHA technology to fight spam. Your use of reCAPTCHA is subject to Google's Privacy Policy and Terms of Service.SUBMITThank you! Your message was sent successfully. Copyright © 2020 / PreviousNextPausePlayClose