Insurance Claims Adjusting and Investigation by D.J. Hannon & Associates, Inc.

Privacy Policy

* = Required Field

Carrier Information
* Claim Submitted By:
Rush Assignment:	Yes No
* Type of Assignment:
* Company:		* Adjuster:
* Claim #:		* Date of Loss:
* Address:		* City:
* State:		* Zip Code:
* Phone Number:		* Email:
Defense Counsel Information
Firm:		Legal File #:
Address:		City:
State:		Zip Code:
Phone Number:		Contact Person:
* Email:
Plaintiff/Claimant Information
* Name:
SS #:		Date of Birth:
Address:		Apt #:
City:
State:		Zip Code:
Phone Number:		Cell Phone #:
Insured Information
* Name:
* Case Information/Special Instructions