email: assignments@naas4u.com
To assign a claim please fill out the form below and then click the submit button, your claim form will then open in your email application, click send in your email application to submit your claim:
Part 1: Assignment Information
Contact Name:
Street Address :
City:
State: Zip Code :
Home Phone Number:
Business Phone:
Insured:
Claimant:
Date Assigned:
Date of Loss:
Claim Number:
Vehicle:
VIN:
License:
Color:
Part 2: Insurance Company Information
Insurance Company:
Phone Number :
Email Address:
Insurance Co. Address:
Adjuster:
Fax Number :