Adjuster Intake Form

Provided by 1 833 Claim Me LLC D/B/A Claim Me

Please answer the questions below and a member from our team will be in touch.

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1. Adjuster Details *

Company Name

Address

Address Line 2

City

receive update what

State

Zip Code

Phone Number

Please enter a valid phone number.

Best point of contact email *

Current PA License #

2. How many public adjusters are in your company?

3. Do you have a law firm you currently refer your denied, delayed, and underpaid claims?

If yes, how many law firms do you currently work with?

4. What do you like most about the law firm(s) you work with? If there’s anything you could change, what would it be?

5. How many claims does your company receive on a monthly basis?

6. Do you have a focus area/location in Florida? Can you adjust in other states?

7. Is making sure your clients receive the best customer service important to you?

8. What is more important to you, repeat business/ referrals or closing claims quickly?

9. Do you handle $10k cap water damage claims?

10. How often do you or your current attorneys update your clients?

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