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Adjuster Resources

Updated Adjuster Information Form

Thank you for taking the time to update your personal information for our adjuster roster. Below you will find the full template requesting your personal information. Please complete the three (3) fields marked with an asterisk (*) and any other information that has changed. If you are here to update your availability only, complete the three (3) fields marked with an asterisk (*) and then the availability section only.

Your updated information will be forwarded to our Catastrophe office for processing.

Please contact us with any questions or comments.

NOTE: Fields marked with an asterisk (*) are required. Also, any information that has changed is required.

Contact Information
First Name:*
Last Name:*
Email:*
Alternate Email:
Street Address:
Street Address (cont):
City:
State:
Zip / Postal code:
Home Phone:
Business Phone:
Cell Phone:
Emergency Contact:
Emergency Contact Phone:
Desired Postion
 

Select the position that best describes your previous claims handling experience. If no experience, select desired position. Please choose top 2 positions:

Desired Position #1:
Desired Position #2:

License Information

Provide information for the licenses you hold in each state. Click the "Add Another License" button below to add fields for additional licenses.
License State:
License Number:
License Expiration Date: select
No License/Pending License:
Certifications

Check all that apply below:
CPIC
TWIA Certified
Shelter
State Farm
Allstate
USAA

Estimating Platform

1st Choice: (Pick one)
Xactimate License #:
Integra License #:
Other License #:

2nd Choice: (Pick one)
Xactimate License #:
Integra License #:
Other License #:

Experience
Light & Heavy Commercial
Light - Yrs Experience: Heavy - Yrs Experience:
Light & Heavy Residential
Light - Yrs Experience: Heavy - Yrs Experience:
Mobile Home
Light - Yrs Experience: Heavy - Yrs Experience:
No Previous Experience

Availability
Preferred Work:
Daily Claims
Catastrophe
Anything Available
 
Currently Deployed:
 
Date Available: select
I am willing to travel.
 
Documents
 
Upload Resume
(DOC or PDF only please):
 
Upon submission, you will receive an email confirmation for your records.
 

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