{"id":148,"date":"2023-06-14T10:02:36","date_gmt":"2023-06-14T14:02:36","guid":{"rendered":"https:\/\/www.nicholasinsurance.net\/?page_id=148"},"modified":"2023-06-15T13:20:32","modified_gmt":"2023-06-15T17:20:32","slug":"file-a-claim","status":"publish","type":"page","link":"https:\/\/www.nicholasinsurance.net\/?page_id=148","title":{"rendered":"FILE A CLAIM"},"content":{"rendered":"\n<div class=\"wp-block-cover alignfull is-light has-custom-content-position is-position-bottom-center\" style=\"min-height:464px;aspect-ratio:unset;\"><span aria-hidden=\"true\" class=\"wp-block-cover__background has-background-dim\"><\/span><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"683\" class=\"wp-block-cover__image-background wp-image-151\" alt=\"\" src=\"https:\/\/www.nicholasinsurance.net\/wp-content\/uploads\/2023\/06\/A0029886-1200x800-1-1024x683.jpg\" style=\"object-position:45% 50%\" data-object-fit=\"cover\" data-object-position=\"45% 50%\" srcset=\"https:\/\/www.nicholasinsurance.net\/wp-content\/uploads\/2023\/06\/A0029886-1200x800-1-1024x683.jpg 1024w, https:\/\/www.nicholasinsurance.net\/wp-content\/uploads\/2023\/06\/A0029886-1200x800-1-300x200.jpg 300w, https:\/\/www.nicholasinsurance.net\/wp-content\/uploads\/2023\/06\/A0029886-1200x800-1-768x512.jpg 768w, https:\/\/www.nicholasinsurance.net\/wp-content\/uploads\/2023\/06\/A0029886-1200x800-1.jpg 1200w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><div class=\"wp-block-cover__inner-container is-layout-flow wp-block-cover-is-layout-flow\">\n<h2 class=\"wp-block-heading has-text-align-center has-color-light-color has-text-color has-large-font-size\" style=\"font-style:normal;font-weight:100;letter-spacing:5px;text-transform:lowercase\">Preliminary Claim Information<\/h2>\n<\/div><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">It happens! And when it does, we&#8217;re here for you.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Please give us some background information about your loss, and we will contact you as soon as possible.<\/p>\n\n\n<div class=\"wpforms-container wpforms-container-full wpforms-block wpforms-block-41860075-dbac-49d3-8050-868f5b749034 wpforms-render-modern\" id=\"wpforms-142\"><form id=\"wpforms-form-142\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"142\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F148\" data-token=\"88d0d4f36ec9a25965431ab40b6719f2\" data-token-time=\"1780169364\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div id=\"wpforms-error-noscript\" style=\"display: none;\">Please enable JavaScript in your browser to complete this form.<\/div><div class=\"wpforms-field-container\"><div id=\"wpforms-142-field_41-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"41\"><fieldset><legend class=\"wpforms-field-label\">Name of Insured <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-142-field_41\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][41][first]\" aria-errormessage=\"wpforms-142-field_41-error\" aria-describedby=\"wpforms-142-field_41-description\" required><label for=\"wpforms-142-field_41\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-142-field_41-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][41][last]\" aria-errormessage=\"wpforms-142-field_41-last-error\" aria-describedby=\"wpforms-142-field_41-description\" required><label for=\"wpforms-142-field_41-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><div id=\"wpforms-142-field_41-description\" class=\"wpforms-field-description\">Name of policyholder.<\/div><\/fieldset><\/div><div id=\"wpforms-142-field_48-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"48\"><label class=\"wpforms-field-label\" for=\"wpforms-142-field_48\">Address <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-142-field_48\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][48]\" aria-errormessage=\"wpforms-142-field_48-error\" required><\/textarea><\/div><div id=\"wpforms-142-field_49-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"49\"><label class=\"wpforms-field-label\" for=\"wpforms-142-field_49\">Phone Number <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-142-field_49\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][49]\" aria-errormessage=\"wpforms-142-field_49-error\" required><\/div><div id=\"wpforms-142-field_47-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"47\"><label class=\"wpforms-field-label\" for=\"wpforms-142-field_47\">Email <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"email\" id=\"wpforms-142-field_47\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][47]\" spellcheck=\"false\" aria-errormessage=\"wpforms-142-field_47-error\" required><\/div><div id=\"wpforms-142-field_50-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"50\"><fieldset><legend class=\"wpforms-field-label\">Preferred Method of Contact <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-142-field_50\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-142-field_50_1\" name=\"wpforms[fields][50]\" value=\"Call\" aria-errormessage=\"wpforms-142-field_50_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-142-field_50_1\">Call<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-142-field_50_2\" name=\"wpforms[fields][50]\" value=\"Text\" aria-errormessage=\"wpforms-142-field_50_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-142-field_50_2\">Text<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-142-field_50_3\" name=\"wpforms[fields][50]\" value=\"Email\" aria-errormessage=\"wpforms-142-field_50_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-142-field_50_3\">Email<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-142-field_52-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"52\"><label class=\"wpforms-field-label\" for=\"wpforms-142-field_52\">Type of Claim <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-142-field_52\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][52]\" required=\"required\"><option value=\"Automobile\"  class=\"choice-1 depth-1\"  >Automobile<\/option><option value=\"Personal Property\"  class=\"choice-2 depth-1\"  >Personal Property<\/option><option value=\"Business Property\"  class=\"choice-3 depth-1\"  >Business Property<\/option><option value=\"Liability\"  class=\"choice-4 depth-1\"  >Liability<\/option><option value=\"Personal Injury\"  class=\"choice-5 depth-1\"  >Personal Injury<\/option><option value=\"Other\"  class=\"choice-6 depth-1\"  >Other<\/option><\/select><\/div><div id=\"wpforms-142-field_30-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"30\"><label class=\"wpforms-field-label\" for=\"wpforms-142-field_30\">Location of Incident <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-142-field_30\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][30]\" aria-errormessage=\"wpforms-142-field_30-error\" required><\/div><div id=\"wpforms-142-field_3-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-142-field_3\">Is there a police report? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-142-field_3\" class=\"wpforms-field-small wpforms-field-required\" name=\"wpforms[fields][3]\" required=\"required\"><option value=\"Yes\"  class=\"choice-1 depth-1\"  >Yes<\/option><option value=\"No\"  class=\"choice-2 depth-1\"  >No<\/option><\/select><\/div><div id=\"wpforms-142-field_5-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-142-field_5\">Responding Police Department<\/label><input type=\"text\" id=\"wpforms-142-field_5\" class=\"wpforms-field-medium\" name=\"wpforms[fields][5]\" aria-errormessage=\"wpforms-142-field_5-error\" ><\/div><div id=\"wpforms-142-field_56-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"56\"><label class=\"wpforms-field-label\" for=\"wpforms-142-field_56\">Incident Report Number<\/label><input type=\"text\" id=\"wpforms-142-field_56\" class=\"wpforms-field-small\" name=\"wpforms[fields][56]\" aria-errormessage=\"wpforms-142-field_56-error\" ><\/div><div id=\"wpforms-142-field_42-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"42\"><label class=\"wpforms-field-label\" for=\"wpforms-142-field_42\">Was anyone injured? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-142-field_42\" class=\"wpforms-field-small wpforms-field-required\" name=\"wpforms[fields][42]\" required=\"required\"><option value=\"Yes\"  class=\"choice-1 depth-1\"  >Yes<\/option><option value=\"No\"  class=\"choice-2 depth-1\"  >No<\/option><\/select><\/div><div id=\"wpforms-142-field_17-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"17\"><label class=\"wpforms-field-label\" for=\"wpforms-142-field_17\">Briefly describe any injuries:<\/label><textarea id=\"wpforms-142-field_17\" class=\"wpforms-field-medium\" name=\"wpforms[fields][17]\" aria-errormessage=\"wpforms-142-field_17-error\" ><\/textarea><\/div><div id=\"wpforms-142-field_54-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"54\"><label class=\"wpforms-field-label\" for=\"wpforms-142-field_54\">Cause of Loss <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-142-field_54\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][54]\" aria-errormessage=\"wpforms-142-field_54-error\" aria-describedby=\"wpforms-142-field_54-description\" required><div id=\"wpforms-142-field_54-description\" class=\"wpforms-field-description\">EX: Impact, Weather, Theft, Vandalism, Hit While Parked, etc.<\/div><\/div><div id=\"wpforms-142-field_6-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"6\"><fieldset><legend class=\"wpforms-field-label\">Name of Driver 1<\/legend><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-142-field_6\" class=\"wpforms-field-name-first\" name=\"wpforms[fields][6][first]\" aria-errormessage=\"wpforms-142-field_6-error\" aria-describedby=\"wpforms-142-field_6-description\" ><label for=\"wpforms-142-field_6\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-142-field_6-last\" class=\"wpforms-field-name-last\" name=\"wpforms[fields][6][last]\" aria-errormessage=\"wpforms-142-field_6-last-error\" aria-describedby=\"wpforms-142-field_6-description\" ><label for=\"wpforms-142-field_6-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><div id=\"wpforms-142-field_6-description\" class=\"wpforms-field-description\">If different than named insured.<\/div><\/fieldset><\/div><div id=\"wpforms-142-field_13-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"13\"><label class=\"wpforms-field-label\" for=\"wpforms-142-field_13\">Vehicle Year, Make, and Model<\/label><input type=\"text\" id=\"wpforms-142-field_13\" class=\"wpforms-field-large\" name=\"wpforms[fields][13]\" aria-errormessage=\"wpforms-142-field_13-error\" ><\/div><div id=\"wpforms-142-field_8-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-142-field_8\">Vehicle Identification Number (VIN)<\/label><input type=\"text\" id=\"wpforms-142-field_8\" class=\"wpforms-field-large\" name=\"wpforms[fields][8]\" aria-errormessage=\"wpforms-142-field_8-error\" ><\/div><div id=\"wpforms-142-field_34-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"34\"><label class=\"wpforms-field-label\" for=\"wpforms-142-field_34\">Briefly describe any vehicle damage:<\/label><textarea id=\"wpforms-142-field_34\" class=\"wpforms-field-medium\" name=\"wpforms[fields][34]\" aria-errormessage=\"wpforms-142-field_34-error\" aria-describedby=\"wpforms-142-field_34-description\" ><\/textarea><div id=\"wpforms-142-field_34-description\" class=\"wpforms-field-description\">If none, type NONE.<\/div><\/div><div id=\"wpforms-142-field_55-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"55\"><label class=\"wpforms-field-label\" for=\"wpforms-142-field_55\">Loss of Item(s)<\/label><input type=\"text\" id=\"wpforms-142-field_55\" class=\"wpforms-field-medium\" name=\"wpforms[fields][55]\" aria-errormessage=\"wpforms-142-field_55-error\" ><\/div><div id=\"wpforms-142-field_18-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"18\"><fieldset><legend class=\"wpforms-field-label\">Name of Claimant<\/legend><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-142-field_18\" class=\"wpforms-field-name-first\" name=\"wpforms[fields][18][first]\" aria-errormessage=\"wpforms-142-field_18-error\" aria-describedby=\"wpforms-142-field_18-description\" ><label for=\"wpforms-142-field_18\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-142-field_18-last\" class=\"wpforms-field-name-last\" name=\"wpforms[fields][18][last]\" aria-errormessage=\"wpforms-142-field_18-last-error\" aria-describedby=\"wpforms-142-field_18-description\" ><label for=\"wpforms-142-field_18-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><div id=\"wpforms-142-field_18-description\" class=\"wpforms-field-description\">Please provide claimant name if different than named insured or driver listed above.<\/div><\/fieldset><\/div><div id=\"wpforms-142-field_44-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"44\"><label class=\"wpforms-field-label\" for=\"wpforms-142-field_44\">Address of Claimant<\/label><textarea id=\"wpforms-142-field_44\" class=\"wpforms-field-medium\" name=\"wpforms[fields][44]\" aria-errormessage=\"wpforms-142-field_44-error\" ><\/textarea><\/div><div id=\"wpforms-142-field_51-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"51\"><label class=\"wpforms-field-label\" for=\"wpforms-142-field_51\">Phone Number of Claimant<\/label><input type=\"text\" id=\"wpforms-142-field_51\" class=\"wpforms-field-medium\" name=\"wpforms[fields][51]\" aria-errormessage=\"wpforms-142-field_51-error\" ><\/div><div id=\"wpforms-142-field_28-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"28\"><label class=\"wpforms-field-label\" for=\"wpforms-142-field_28\">Vehicle Make and Model<\/label><input type=\"text\" id=\"wpforms-142-field_28\" class=\"wpforms-field-large\" name=\"wpforms[fields][28]\" aria-errormessage=\"wpforms-142-field_28-error\" ><\/div><div id=\"wpforms-142-field_38-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"38\"><label class=\"wpforms-field-label\" for=\"wpforms-142-field_38\">Include additional property damage, drivers involved, or other notes:<\/label><textarea id=\"wpforms-142-field_38\" class=\"wpforms-field-medium\" name=\"wpforms[fields][38]\" aria-errormessage=\"wpforms-142-field_38-error\" ><\/textarea><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-recaptcha-container wpforms-is-recaptcha wpforms-is-recaptcha-type-v2\" ><div class=\"g-recaptcha\" data-sitekey=\"6LfhUXgpAAAAAB3cGcuOZYHeCGcZd1DW2BkL99sX\"><\/div><input type=\"text\" name=\"g-recaptcha-hidden\" class=\"wpforms-recaptcha-hidden\" style=\"position:absolute!important;clip:rect(0,0,0,0)!important;height:1px!important;width:1px!important;border:0!important;overflow:hidden!important;padding:0!important;margin:0!important;\" data-rule-recaptcha=\"1\"><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"142\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/www.nicholasinsurance.net\/index.php?rest_route=\/wp\/v2\/pages\/148\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-142\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.nicholasinsurance.net\/wp-content\/plugins\/wpforms-lite\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Loading\"><\/div><\/form><\/div>  <!-- .wpforms-container -->\n\n\n<p class=\"has-libre-baskerville-font-family has-tiny-font-size wp-block-paragraph\" style=\"font-style:normal;font-weight:100;text-transform:uppercase\">It is the insureds responsibility as per the insurance contract to (1) notify your agent or company promptly about where, when, and how the loss occurRed; (2) prevent property from further damage; (3) assist and cooperate with agent and company. <\/p>\n","protected":false},"excerpt":{"rendered":"<p>It happens! And when it does, we&#8217;re here for you. Please give us some background information about your loss, and we will contact you as soon as possible. It is the insureds responsibility as per the insurance contract to (1) notify your agent or company promptly about where, when, and how the loss occurRed; (2) [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-148","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.nicholasinsurance.net\/index.php?rest_route=\/wp\/v2\/pages\/148","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.nicholasinsurance.net\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.nicholasinsurance.net\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.nicholasinsurance.net\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.nicholasinsurance.net\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=148"}],"version-history":[{"count":5,"href":"https:\/\/www.nicholasinsurance.net\/index.php?rest_route=\/wp\/v2\/pages\/148\/revisions"}],"predecessor-version":[{"id":251,"href":"https:\/\/www.nicholasinsurance.net\/index.php?rest_route=\/wp\/v2\/pages\/148\/revisions\/251"}],"wp:attachment":[{"href":"https:\/\/www.nicholasinsurance.net\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=148"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}