File a Claim

Grindell & Romero Insurance will see that your claim is handled quickly and efficiently. Please fill out the form below to start the claim process.

Policy Number:*
Date
Insured Information
Insured Contact Name*
Insured Contact Email*
Insured Contract Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Description of Loss
Describe details of loss*
Location of occurrence including city and state*
Insured Contractor License Number
Date work started*
Date work completed*
Please attach any documents/files related to claim:
Claimant Information
Claimant Name*
Claimant Phone
Claimant Business Name
Claimant Email
Submitted By
claim reported by*
Relationship to Claim*

Insured Information