If this is an emergency claim, please call 1 (800) 466-9165 and advise the operator that the claim requires the utmost attention, and you need an immediate response. If the claim is not an emergency, please complete the form below and our office will contact you within 24 hours.

Raphael & Associates Assign Marine Claim Form
  • Client Information
  • Name*
  • Company*
  • Street*
  • City*
  • State*
  • ZIP Code*
  • Home Phone*
  • Work Phone*
  • Email*
  • Claim Number*
  • Insured Information
  • Name*
  • Street*
  • City*
  • State*
  • ZIP Code*
  • Home Phone*
  • Work Phone*
  • Loss Information
  • Vessel Name*
  • Vessel Year*
  • Vessel Make*
  • Vessel Number*
  • Captain's Information*
  • Loss Type*
  • Date of Loss*
  • Location of Occurrence*
  • Loss Description*
  • Contact Our Insured and:*
  • Additional Comments*
  • Contact the claimant(s) and:*
  • Additional Comments*
  • Miscellaneous:*
  • Additional Comments*

Your claim is very important to the Raphael & Associates team, and it is of the utmost importance that we not only meet but exceed expectations. Please advise us if you have any questions of concerns that we can address.


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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