Claims Information:
Company: General Insurance Company
Office: 123 Oak St. Elmira NY.12544
Phone: 525-222-5555 Fax: 525-222-5550 E-mail: insurance@gic.com
Adjuster: Mr. Demo Adjuster
Office: 123 Oak St. Elmira NY. 12544
Phone: (direct) 525-222-5554 Fax: 525-222-5550 E-mail demo.adjuster@gic.com
Claimant: Robert Bolster & Mary Bolster
Insured: Same
Address of insured: 100 Elm St. Elmira NY 12543
Location of loss: same
Phone: (home) 525-123-4567 (cell) 525-567-2002 E-mail: robert.b@comcast.net
Date of Loss: 11-1-XXXX
Policy#: ABC1234567
Claim#: ABC1234567
Policy period: 1-1-XXXX to 12-31-XXXX
Type of loss: property
Coverage: Homeowners 3
Describe loss: Water has been flooding the basement of the insured’s home. The insured thinks it the result of a broken water main. His bills have been rising steadily approximately doubling in a year’s time. He had been pumping the water into the septic tank. The septic tank filled with sand which required a new installation. Insured has contacted the water department.
Vendor assigned: Diverka & Bartilucci Engineers
Office: 100 Main St. Elmira NY. 12530
Phone: 525-202-4321 Fax: 525-202-4322 E-mail: d&b@bdengineers.com
Instructions: Go to the site and determine, if possible, the cause of the flooding. Contact the water department regarding their plans. The water department may decide to excavate the water line to determine if in fact the water line has a break. Call for authorization to observe. Digital photos should be included in your report.