Rent Default Insurance Claim
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Begin The Claim
What is your relationship to the claim?
Your First Name
Your Last Name
(A copy of this Web Reported Claim will be sent to the below e-mail address.)
Date of Loss
Type of Default
Inactive Member of Military Placed on Active Status
Death of Sole Tenant
Address Where Default Occurred
Monthly Rental Income for This Unit
Number of Months Rent in Arrears
Amount of Legal Expenses Incurred (if any)
Check if same as person reporting the claim
Company Name (if applicable)
Your claim is now ready to submit.
Any other information to support your claim.
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** You may upload the following information to facilitate the claim process:
A copy of the lease for the rental unit in force at the time of the rent default.
Evidence of the pre-lease screening checks on the tenant of the rental unit substantiating that the tenant met the screening criteria outlined in the policy.
Copies of notices sent to the tenant of the rental unit regarding rent payments.
Copies of any legal documents relating to eviction proceedings.
Receipts or invoices to substantiate any legal expenses.