Submit an Insurance Claim Assignment

Are you a policyholder? To report a new loss under your policy, contact your insurer first. For help with an existing HGM assignment, contact our team.

Share the details you have. Required fields are marked; policy details and supporting documents can be provided later.

01 Your details

Examiner / contact name (required)

Your email address (required)

Your phone number (required)

Insurance company (required)

02 Insured & policy

Insured name (required)

Insured phone number (optional)

Mailing address (optional)

City (optional)

Province / territory (optional)

Postal code (optional)

Policy number (optional)

Policy inception date (optional)

Deductible (optional)

Enter an amount and currency, if known.

03 Loss details

Claim number (required)

Date of loss (required)

Loss address is the same as the insured mailing address

Loss address (required)

Loss city (required)

Loss province / territory (required)

Loss postal code (optional)

Describe the loss and the support needed (required)

04 Supporting documents

Attach documents (optional)

Up to 5 PDF, JPG or PNG files; 2 MB total. For larger files, contact our team to arrange a transfer.

Your information will be used to respond to this request. Read our privacy policy.

An assignment is subject to our team’s review. Submission does not confirm acceptance of the assignment or coverage.

Assign a claim to HGM.