Report a Claim | Independent Mutual Fire Insurance Company

Claim Type*

First Name*

Last Name*

Phone Number

Best Time To Reach You:

Email*

Policy Number (If Applicable)

Date of Loss

Loss Address

Street Address Address Line 2 City State ZIP Code

Temporary Address

Street Address Address Line 2 City State ZIP Code

Is Mailing Address Different than Loss Address?

Mailing Address

Street Address Address Line 2 City State ZIP Code

Brief Description of your Loss Including Type of Loss (Fire, Lightning, Water, Smoke, etc)

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