Report a Claim

Columbia Lloyds and MDOW Insurance Company are here for you.

Sometimes there are a lot of things to keep track of during an insurance claim and you don't know where to start...or what to do next. Since every claim is different, contact us once you can about what happened. Your claims team member will assist you in getting this claim processed and also provide you with a list of what information may be needed for the type of claim you are filing.

Claims Department Contact
Please enter the policy number and the contact number to reach us will be provided.

Policy Information
Policy number		Policy type	Homeowner / Fire Dwelling Farm Property Auto
Insured first name		Insured last name

Contact Information
First name		Last name
Street/Apt number		City
State	Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Guam Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Virgin Islands Vermont Washington Wisconsin West Virginia Wyoming Other Country	Zip
Email Address		Confirm Email Address
Do you prefer email correspondence?	Yes No	Call back	As soon as possible At specified time
Best phone number		Preferred Call back time	am pm
Home phone		work phone
Cell phone		Alternate phone
Business name

Loss Information
Loss Date		Loss Time	am pm
Cause of loss	Accidental Discharge/LeakageAll OtherAll Other Physical DamageApplianceCollision, Upset, OverturnContaminationCredit CardCyber AttackDamage to Property of OthersDog BiteEarth MovementEarthquakeEquipment BreakdownExtended Coverage PerilsFireFloodForeign ObjectFreezing Water and Subsequent Water DamageHailIdentity TheftIdentity Theft RestorationLiabilityLighteningLivestockLoss Adjustment ExpenseMedical PaymentsMoldMysterious DisappearanceMysterious Disappearance Involving Scheduled PropertySinkholeSlip/FallSmokeTheft, Involving Scheduled PropertyTheft/BurglaryUtility Service LineVandalism/Malicious MischiefWater DamageWatercraftWeatherWindWorker’s Compensation
Equip breakdown desc	HVAC Electrical HVAC mechanical Mechanical Water heater/ heat pumps Boiler Machinery Computers and computer controlled equipment Electrical panels Home security Systems Well water pumps, pool pumps and sump pumps Dishwashers, clothes washers and dryers Refrigerators, freezers, clothes washers and dryers Other
Cyber Attack desc	Identity Theft Expenses Credit Card Fraud, Forgery, Cyber Crime Cyber Extortion Cyber Bullying Breach Notification Costs
Loss Description
Loss Location
Address		City
State	Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Guam Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Virgin Islands Vermont Washington Wisconsin West Virginia Wyoming Other Country	Zip

Agent Information
Name of Insurance Company		Address
Name of Insurance Agency		City
Email Address		State
Phone		Zip