First Notice of Loss (FNOL)

Type of AMERIND customer:*
- Homeowner
We apologize, unfortunately your First Notice of Loss (FNOL) may NOT be submitted online. Please email your FNOL or any questions about the claims process to: PCFNOL@amerind.com Thank you!
Insured Contact Name*
First Last
Contact Phone # (Preferably Cell #)*
Insured Address (Policy Location)*
Street Address Address Line 2 City State ZIP Code
Email*

All claim information such as Acknowledgement letter, Declination letters and Settlement forms will be sent to the email listed above. As well as our Third Party Adjuster will be in contact with the Insured to schedule the site inspection via the contact information listed above.

Claimant Information
Claimant Name
First Last
Claimant Address
Street Address City State / Province / Region ZIP / Postal Code
Claimant Phone Number
Claimant Date of Birth
MM slash DD slash YYYY
Claimant Email Address
Claimant SSN
Description of Incident
Attach Incident Report:
Drop files here or

Max. file size: 100 MB.
Property
(Peril) Choose a Loss Type*
Peril Description*
How did the loss occur?*
Please provide a brief description of the cause of your loss. (Example descriptions: a fire on the stove from a cooking accident OR water damage from an interior frozen pipe burst.)
Describe the damages sustained from Cause of Loss to the dwelling.*
(Example descriptions: fire damaged my cabinets, flooring, walls, windows, and personal contents OR water damaged my flooring, walls, and personal contents)
Damage sustained under policy*
- Coverage A – Dwelling
- Coverage B – Other Structures (de-attached garage/shed, fences or pools, etc.)
- Coverage C – Personal Contents
- Coverage D – Loss of Use (Incurred expenses while home is unlivable. Receipts required.)
Occupancy Status*
Utility Status*
Have you taken photos?*
Photos
If you have suffered a total loss or water loss, photos are recommended.
Drop files here or

Accepted file types: jpg, png, bmp, jpeg, Max. file size: 10 MB, Max. files: 10.

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