Flooded Basement Damage Claim Form
Policyholder Information
Full Name
Policy Number
Property Address
Phone Number
Email Address
Incident Information
Date of Incident
Describe the Cause of Basement Flooding
Date Damage Was Discovered
Date Claim Was Reported
Damage Details
Summary of Damages
Estimated Cost of Damages
Actions Taken (e.g., water removal or repairs)
Contractors or Services Contacted
Upload Photos of Damage