Raphael & Associates Homeowner Claim Form
  • INSURED INFORMATION
  • Name*
  • Contact Name*
  • Contact Phone Number*
  • Contact Email Address*
  • Street*
  • City*
  • ZIP*
  • Home Phone*
  • Work Phone*
  • Cell Phone*
  • LOSS INFORMATION
  • Policy Number*
  • Retail Broker Email Address*
  • Date of Loss*
  • Description of Occurrence*
  • Location of Occurrence*
  • Additional Comments*
ABOUT US
Raphael & Associates is a TPA and claims adjusting company internationally recognized for its exceptional service and unsurpassed reputation of nationwide claims handling. We understand the importance of adapting to the demands of a dynamic market and tailor our services to our client's specific needs. Our mission is simple: to provide outstanding service, extraordinary professionals and the best that technology has to offer.

Raphael & Associates

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