Claims Form - Lexington Insurance Company

Catastrophic First Notice Of Loss

New Claims:

This website is intended solely for the benefit of Lexington Insurance Company policyholders.
Please provide as much information as possible
Then click "submit" or print and fax to :

Homeowners/Personal Lines: 1.866.603.5519 (fax)
Business/Commercial Lines: 1.866.612.8014 (fax)

Fields containing * (in red) are required

*=Required

Policy Information

Policy Prefix:

(letters preceding the policy number)

Policy Number:

Insured Information

Insured Name:

Street Address:

City:

State:

Zip Code:

Home or Temporary Phone:

Mobile Phone:

Email Address:

Information About Person Reporting Loss

Name of Person Reporting Loss:

Reporter's Home Phone:

Reporter's Mobile Phone:

Reporter's Email:

Information About This Loss

Date Of Loss:

Location of Loss:

Description of Loss & Damage:

Additional Remarks

Additional Remarks:

Please type in the SECURITY CODE