Report a Claim | Etude Insurance

Your information

Fields marked with an asterisk are required.

First name *

Last name *

Email *

Phone *

I am reporting as *

Company

Title / position

Policy & loss location

Use the named insured shown on the policy. Include your policy number if available.

Named insured / policyholder *

Policy number

Policy effective dates

Insurance product

Property name

Loss location street address *

City *

State *

ZIP code *

What happened

Provide a brief description of the incident and the damage or injury reported.

Date of loss *

Time of loss, if known

Type of claim *

Cause of loss

Other cause or additional causes

Description of loss *

Estimated damage ($), if known

Assets damaged

Property inspected after the incident?

Photos & documents

Add available photos, repair estimates or incident reports. You can report the loss before all documents are available.

Photo of damage

Upload File

Max file size 10MB.

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Additional photo

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Max file size 10MB.

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Repair estimate

Upload File

Max file size 10MB.

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Supporting document

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Max file size 10MB.

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Additional details

Complete the sections that apply to this claim.

Insured contact & mailing address

If different from the reporter above.

Primary contact

Contact phone

Contact email

Mailing address

City

State

ZIP

Witnesses & responding authorities

Include witnesses and any police, fire or other authorities who responded.

Witness names and contact details

Authorities contacted?

Department and report number

Other party involved

If another party may have contributed to the loss.

Party name

Relationship to insured

Party address

Insurance carrier and policy

Describe their involvement

Liability claimant & legal documents

For third-party injury or property damage claims, including claims involving tenants.

Claimant name

Claimant phone

Claimant email

Claimant address

City

State

ZIP

Injury description

Third-party property damage

Attorney name

Law firm

Attorney phone

Attorney email

Demand, lawsuit or other legal document

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Max file size 10MB.

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Other insurance & mortgagee

Other coverage that may apply and any lienholder on the property.

Other policies?

Mortgagee / lienholder

Other insurance details

Immediate actions & mitigation

Steps already taken to secure the property and limit further damage.

Emergency services called?

Property secured?

Mitigation steps

Mitigation contact name

Contact phone

Contact email

Mitigation cost ($)

Confirm & submit

Reporting a claim does not confirm coverage. Coverage is subject to the terms, conditions, limits and exclusions of the applicable policy.

Your name and title *

I certify that the information provided is true and accurate to the best of my knowledge.

Your claim report has been received. Please keep copies of your supporting documents.

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