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File a Claim

Give us the details and we’ll take it from there.

Filing online counts as a claim on your policy once an adjuster contacts you — even if the loss turns out not to be covered. If you’re unsure whether your loss is covered, talk to your agent first, or call us at 336.625.6323. Fields marked * are required.

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Policy & Contact Information

Insured Name *

Policy Number *

Agent Name

Address *

City *

State *

ZIP Code *

Phone (Home/Cell) *

Phone (Work)

Email *

Contact Person

Best Time to Contact

Loss Details

Date of Loss *

Time of Loss

Date Form Completed

Location of Loss *

Type of Loss *

Reported to Fire Department?

If yes, what agency responded?

Describe the Loss *

Mortgage on property where loss occurred?

Policy Deductible ($)

Other insurance covering this property?

Remarks

Who Is Filing This Report

Reported By *

Reported To

Your Phone Number *

Relation to Insured *

Your Email *

Attachments & Certification

Attach photos or documents (optional)Up to 6 files, 15 MB each — PDF, images, Word, or Excel.

I hereby certify that I am the named insured or agent of record and therefore have the authority to submit this request. *

Signature of Insured / Person Completing Form *

A mutual insurance company owned by our policyholders — protecting North Carolina homes, farms, and families since 1892.

Get in Touch

515-A West Salisbury St.
Asheboro, NC 27203

336.625.6323
888.889.5093

Fax: 336.625.8417

Mon–Thu 8:00 AM – 4:00 PM
Fri 8:00 AM – 12:00 PM

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