Contact Information - Property & Liability Resource Bureau

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Contact Information

First Name(Required)

Last Name(Required)

Phone Number

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Email

Professional Designation

Job Title(Required)

Company Name(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

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Please select from the following which closely describes your job function

Claims Adjuster / Analyst / Representative / Specialist

Claims Attorney

Claims Supervisor / Manager / Vice President / Officer

Claims Trainer

Claims Training Manager

Desk Adjuster

Executive General Adjuster

Product Manager (Underwriting)

Project Manager (Claims)

Project Manager (Underwriting)

SIU Investigator

Subrogation Specialist

Underwriter

Underwriting Manager

Underwriting Officer

Underwriting Supervisor

Underwriting Vice President

Please select the best fit for your functional area:(Required)

Please select the best fit for the level of your current role(Required)

Please select the best fit for your functional area other:

Please select the best fit for the level of your current role other:

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Personal/Commercial Lines

Personal

Commercial

Both Personal & Commercial

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Property/Liability Policies

Property

Liability

Both Property & Liability

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Select All Claim Types You Handle

Auto

Commercial / BP / CP

GL / Business Liability

HO / Dwelling / Unit Owners

Inland Marine / BR / Motor Truck Cargo

Large Loss

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The State Where You Physically Reside

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States that you handle claims:

ALL STATES

AK (Alaska)

AL (Alabama)

AR (Arkansas)

AZ (Arizona)

CA (California)

CO (Colorado)

CT (Connecticut)

DC (District of Columbia)

DE (Delaware)

FL (Florida)

TX (Texas)

UT (Utah)

VA (Virginia)

VT (Vermont)

WA (Washington)

WI (Wisconsin)

WV (West Virginia)

WY (Wyoming)

GA (Georgia)

HI (Hawaii)

IA (Iowa)

ID (Idaho)

IL (Illinois)

IN (Indiana)

KS (Kansas)

KY (Kentucky)

LA (Louisiana)

MA (Massachusetts)

MD (Maryland)

ME (Maine)

MI (Michigan)

MN (Minnesota)

MO (Missouri)

MS (Mississippi)

MT (Montana)

NC (North Carolina)

ND (North Dakota)

NE (Nebraska)

NH (New Hampshire)

NJ (New Jersey)

NM (New Mexico)

NV (Nevada)

NY (New York)

OH (Ohio)

OK (Oklahoma)

OR (Oregon)

PA (Pennsylvania)

RI (Rhode Island)

SC (South Carolina)

SD (South Dakota)

TN (Tennessee)

Select all lines of business you currently handle:(Required)

Password(Required)

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Direct Approval key

Email

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NAME

EMAIL

Comments

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