Leavitt Group of Boise - Submit Claim

Submit a Claim
We strive to make submitting a claim as easy and quick as possible. Please note that with some insurance carriers you can contact the company directly to submit your claim. To find the direct claim contact phone number for your carrier, click here.

Name of Insured: *	Home Telephone: *
Work Telephone:	Other Telephone (Cell):
Date of Claim:	Time of Claim:
Insurance Company:	Insurance Type:
Type of Claim:

Brief Description of Claim:

Other People Involved and their Contact Information:

List Authorities that were Called:

Any Other Pertinent Comments:

After submitting this form, we will contact you as soon as possible.

Please note this is an alternative method for communicating with us. If you have any questions or need immediate help with your claim please give us a call.