Home
About Us
Our Services
Submit a Claim
Resources
Work For Us
Contact Us

Accurate, Efficient,

& Deligent

icon slider

Liability Claims

service area

"*" indicates required fields

Client information

Your Name*

Office Phone*

Your Company*

Address*

Street Address City State ZIP Code

Fax Number

Email*

Claim & Assignment Details

Claim Number*

Policy Number

Claim Type*

Date of Accident or Incident*

MM slash DD slash YYYY

Incident Involved*

Assignment Level*

Incident Location*

Street Address City State ZIP Code

Interviews and Statements

Do Not Contact

Insured

Claimant

Witness

Interview Only

Insured

Claimant

Witness

Written Statement

Insured

Claimant

Witness

Recorded Statemen

Insured

Claimant

Witness

Statement Summary

Insured

Claimant

Witness

Accident - Incident Description

Assignment Instructions

Policyholder / Claimant Information

Policy Holder Name

Policy Holder Contact Person

Policyholder Address

Street Address City State ZIP Code

Policyholder Home Phone

Policyholder Work Phone

Policyholder Cell Phone

Claimant Name*

Claimant Contact Person*

Claimant Address*

Street Address City State ZIP Code

Claimant Cell Phone*

Claimant Work Phone

Claimant Home Phone

Damage Information

Was anyone injured

Property Damage

Witnesses

Injured Party Details

Property Damage Details

Agent Name

Agent Phone

Name

This field is for validation purposes and should be left unchanged.

Contact Information

Office: 936-775-8113
Toll Free: 888-669-1750

3011 Hwy. 30 West
Suite 101-119
Huntsville, Texas 77340

Email: claims@crossclaims.net
Emergency Contacts: 713-705-1059

© 2022 Cross Claims. All Rights Reserved. Web Design by Appnet.com | Sitemap