ZOLOFRA INSURANCE AGENCY

Ready to protect you today for what matters tomorrow.

Notice of Claim or Loss

CHECK OUT OUR NEW AND IMPROVED WEBSITE AT:

WWW.ALLPROCOVERAGE.COM

 

AM/PM?
AM
PM
*Type of Accident/Claim
Property
Automobile
Workers Compensation
General Liability
Professional Liability (E&O)
Employment Practices Liability
Other


*Any of the following parties notified?
Fire Department
Police
None

For Property Claims, is the Property habitable?
Yes
No

 

* indicates a required field.

Please utilize the "Submit" Button to send your form to our office.  If the website does not allow you to submit the form, please print the page and fax it to 732.334.0405 or scan it into your computer and send it to ben@zolofrainsurance.com.  Do not "Refresh" the page because all data entered onto the form will be lost.