Letter of Representation Wizard
Get Started with the Wizard
Step #1
Have you filed a claim already?
Step #2
Enter the full name of first named insured.
Is the first named insured a corporation?
Step #3
Does your policy include any additional named insureds?
Step #4
Enter the full name of any additional named insured.
Click the "+ Add another named insured" link to add multiple names.
Step #5
Select which of the following people will be available to sign:
Step #6
Enter the contact info for each available person:
Step #7
Who would you like to be the point of contact?
Step #8
Enter the phone number for the selected point of contact:
Step #9
Enter the client's address where the loss occurred.
Step #10
Enter the client's mailing address.
This address is the same as the client's loss address.
Step #11
Enter the estimated dollar amount suffered.
$
Step #12
Do you know the particular ClaimPros' public adjuster you would like to work your claim?
Step #13
Select the public adjuster's information below.
Step #1
Have you filed a claim already?
Step #2
Enter the full name of first named insured.
Is the first named insured a corporation?
Step #3
Does your policy include any additional named insureds?
Step #4
Enter the full name of any additional named insured.
Click the "+ Add another named insured" link to add multiple names.
Step #5
Select which of the following people will be available to sign:
Step #6
Enter the contact info for each available person:
Step #7
Who would you like to be the point of contact?
Step #8
Enter the phone number for the selected point of contact:
Step #9
Enter the client's address where the loss occurred.
Step #10
Enter the client's mailing address.
This address is the same as the client's loss address.
Step #11
Is this a claim based on a catastrophic event?
Is this a declared disaster by the governor of within one year of the anniversary of the event?
Step #12
What percentage do you want to charge the client for this ?
What is the percentage you want to charge your client?
%
Step #13
Are you adding a public adjuster apprentice to this claim?
Step #14
Select the public adjuster apprentice's information below.
Step #1
Have you filed a claim already?
Step #2
Enter the full name of first named insured.
Is the first named insured a corporation?
Step #3
Does your policy include any additional named insureds?
Step #4
Enter the full name of any additional named insured.
Click the "+ Add another named insured" link to add multiple names.
Step #5
Select which of the following people will be available to sign:
Step #6
Enter the contact info for each available person:
Step #7
Who would you like to be the point of contact?
Step #8
Enter the phone number for the selected point of contact:
Step #9
Enter the client's address where the loss occurred.
Step #10
Enter the client's mailing address.
This address is the same as the client's loss address.
Step #11
Is this a claim based on a catastrophic event?
Is this a declared disaster by the governor of within one year of the anniversary of the event?
Step #12
What percentage do you want to charge the client?
What is the percentage you want to charge your client?
What percentage do you want to charge the client for this ?
%
Step #13
Select the sponsoring public adjuster's name:
Step #
Do you have a copy of the declarations page of your current insurance policy?
Step #
What is the actual date of the claim?
Step #
What was the cause of the loss?
Step #
What are the effective and end dates of the policy?
Step #
Are you going to charge your client a fee for handling the adjustment of their additional living expense (ALE) reimbursements?
Step #
Choose all that apply:
Do you have any direct or indirect interest in or compensation by any construction firm, salvage firm, building appraisal firm, storage company, or any other firm or business entity that performs any work in conjunction with damages incident to any loss which the adjuster has been contracted to adjust?
Do you have any direct or indirect participation in the reconstruction, repair, or restoration of damaged property that is the subject of a claim adjusted by the adjuster or disclosure of any other activities that may be reasonably construed as a conflict of interest, including a financial interest in any salvage, repair, construction, or restoration of any business entity that obtains business in connection with any claims that the public adjuster has a contract or agreement to adjust (which is specifically prohibited in 33-23-43.8 (g))?
Do you have any direct or indirect compensation of value in connection with an insured’s specific loss other than compensation from the insured for service as a public adjuster?
Not applicable
Ready to Retain ClaimPros
You are now ready to create your agreement. Please review the information below first, then click the "Create Agreement" button to generate a PDF version of this agreement if everything looks correct.
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Click the button below to download the PDF agreement document.