WE ARE YOUR PROPERTY DAMAGE LAW FIRM
Thank you for choosing Law Offices of Scott Klotzman, P.A. to support you through the property damage insurance claim process. We strive to produce outstanding results while expediting your claim in a timely manner.
DIRECTIONS: Please fill out our client information form below, to the best of your ability.
Once received, our office will review and connect. Expect to sign a retainer so you can secure our services and we can begin to expedite your claim. Remember, claim reviews are free and we only collect if you do. If you have any immediate questions, please do not hesitate to email us at help@scottklotzman.com or by phone at 954-807-3959 or toll free at 1-877-321-PDLF
Full Name *
Property Address *
Phone Number *
Email Address *
Insurance Company: *
Full Name of any additional Insured(s) Listed on Policy
Policy Number: *
Is there a Mortgage listed on the Policy? *
Cause of Loss *
Date of Loss: *
MM
/
DD
/
YYYY
Please give a brief description your matter? *
Was your Insurance Company notified? *
Claim Number:
Did your Insurance Carrier request any of the below?
Clear selection
What is the Current Response from the Carrier? *
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