Homeowners

Report a Claim

You can either report a claim directly to us or to your insurance company. If you would like to report an automobile claim directly to us, please contact us at

Farquhar & Black Insurance Agency

85 Exchange Street

Lynn, MA 01901

Ph: 781.599.2200

info@FarquharandBlack.com

Or simply fill in the form below and press the Submit button to submit information to receive a quote on auto insurance. We will be happy to get back to you soon. Your information will be submitted to our secure server. Your privacy is important to us. Please see our privacy policy for more information.

Homeowners Notice of Claim

No coverage is bound until you are contacted by one of our representatives

General Information

Name

Street Address

City, State, Zip

Phone Number(s)

Home Work

Policy Number

Insured Name, if different

Loss Details

Date of loss

Location of loss

Type of loss

Estimated total value of loss

Reported to Police or Fire Dept?

If yes, name of Dept

If yes, report number

Description of loss and/or damage

Security Code :

Licensed in MA, ME, NH, and NY

info@FandBInsurance.com
85 Exchange Street • Lynn, MA 01901 • Ph. 781.599.2200

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