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File A Claim

 

 

 
Claimant Company Name*:
Contact Name*:
E-mail*:
Telephone*:
Fax Number*:
Address*:
 
City*:
State/Province*:
Zip/Postal Code*:
Country:

Article Description of damage Weight Invoice Cost Amt Claimed

Total Amount Claimed*:

* Required fields

 

 

In addition to the information stated above, the following documents will be submitted in support of my claim.

Please E-mail, fax or mail these supporting documents as soon as possible.

Make sure to include the claimant name, phone number, and contract number along with the documentation.  

Mailing Address: GSIS, 2512 Artesia Boulevard, Suite 250, Redondo Beach, CA. 90278  Fax: (310) 374-2431

Email: claims@subrogatewayusa.com

Invoice To Support Insured Value

Document to support weights of damage/missing articles

Document to support repair cost

Copy of original insurance certificate, if applicable

Photos including a good overview of the item(s) damaged and the specific parts that are damaged

Bill of Lading or Shipping Documents.

 

If claim is more than $2500. Confirm Contact Name, Company Name, Phone Number, E-mail and Address of where damage cargo is located for survey to be assigned.

Remarks:

The best way to contact you is: 

 

 

Contact us today for policy underwriting services, claims management, and data interpretation.

 
 
 
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