Claim Oversight Request Form Requestor InformationCompany Name(Required) Contact Name(Required) First Last Contact Email(Required) Contact Phone(Required)Oversite InformationLine of Business to be overseen(Required) Workers' Compensation Claim General Liability Auto Physical Damage Estimated Number of Claims(Required)Estimated length of time of oversight efforts(Required) This service will be on a monthly retainer that is determined once discussed with inquiring party, a monthly status report will be provided with status updated from both a claim oversight and financial oversight perspective. Please enter TBD if timeline is not determined as of time of request.
