Adjuster Contact Information & Experience Update

Please fill out Name/Email even if not interested in working with us so we can update your file.

If you are NOT interested in working with us, once Name/Email on this page is complete, mark "No" on question 5 to complete the survey and we will remove you from our roster.

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* 1. Name

First name

Middle Name

Last name

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* 2. Email Address

Email address

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* 3. Cell Phone Number

Country Code

Cell Phone number

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* 4. Do you agree to receive text messages to this number related to local claim assignments or potential deployments? We will not send you spam or general advertisements and you may cancel at any time.

Yes

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* 5. Do you wish to remain on our adjuster roster to be considered for future assignments?

Yes - Please consider me for future work opportunities.

No - I do not wish to work for Claims 411 now or in the future. Please do not contact me further. After selecting this option and submitting this page, the survey will conclude.

Question Title

* 6. What work are you interested in doing?

Property Adjusting

General Liability Investigation

Vehicle Accident & Trucking Liability Investigation

Cargo Inspections / Cargo Surveys

Auto, Vehicle, Motorcycle, Truck, Trailer, Construction Equipment, Farm Equipment, Heavy Equipment, Marine, Watercraft, and/or Boat Appraisals

Property Underwriting Inspections

Flood Claims

Crop Claims

Please list any other claim specialties you are capable of doing:

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* 7. Are you currently willing to work claims as an independent adjuster / appraiser?

Yes

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* 8. Are you available to work claims (check all that apply)....

Business Hours (approximately 8am-5pm)

After Business Hours (weekdays)

Weekends

I am not available and/or am no longer adjusting claims.

Other (please specify)

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* 9. Are you able to speak any languages other than english with moderate or better fluency:

Spanish

Other (please specify)