SubroTech Claim Services - Investigation Request Form

Submit a Request

To request any of our services, fill out as much of the form as possible and then click the "Send Request" button at the bottom of the page.

If you are a returning customer and there are no changes in your contact information simply fill out your name and client number when submitting a request. Feel free to call or email us if you need your SubroTech client number.

LOCATION & ASSET REQUEST FORM

YOUR COMPANY INFORMATION:

SubroTech Client #
Company
Address
City
State
ZIP+4
Your Name
Email Address
Phone Number
Fax Number

YOUR CLAIM INFORMATION:

Claim #
Full Name of Insured
Loss Date
Loss Amount

SUBJECT INFORMATION:

(Please provide any copies of police or incident reports via fax or email. Reference your claim number when sending supporting documents. Insurance verification request must include previously researched policies, if claim was denied, and the city where tickets were issued. Property damage claims must include the address where the damage occurred to better search permits issued by city or county building departments.)
Subject Details:
1. Name
2. Spouse
3. Address
4. City
5. State
6. ZIP+4
7. Phone #
8. Social Security Number
9. Date of Birth
10. Driver's License #
11. Issuing State
12. License Expiration
Is this a Current Address?
1. - Yes
  - No
  - Don't Know
Employer / Any Known Occupation:
1. Employer
2. Job Title
3. Address
4. City
5. State
6. ZIP+4
7. Phone #
Is this the Current Employer?
1. - Yes
  - No
  - Don't Know
Involved Vehicle:
1. Vehicle Plate
2. State
3. Make / Model / Year
4. VIN
5. Registered Owner
6. Address / Phone
Loss Location (Physical Address / City where tickets issued or damage occurred)
Loss Type
1. - Auto Accident
  - Fire
  - Vandalism
  - Other (explain below)
Special Request / Additional Information:
For Insurance Verification, please list any policies already researched in the area above. This prevents duplication of effort that consumes valuable research hours. Navigating any claims department by telephone requires patience and time.
File upload:
If available, please upload any police or incident reports above.

PERMISSIBLE PURPOSE:

Submitting a request requires acknowledging our permissible purpose requirements. By submitting this request, the requestor is confirming and providing proof that they have a permissible purpose as defined by federal law.
Check this box to confirm you have a valid permissible purpose

Once your information is entered, click the "Send Request" button to continue.

SubroTech Claim Services

PO Box 150580
Lakewood, CO 80215-0580
800-888-3302 Voice
800-688-3302 Fax

investigate@subrotech.com