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Claim Reporting Form
Brown Insurance Customer Information
*Your Company Name:
*E-Mail:Valid e-mail is required
Claim Information
Explain what happened:
Address of Loss:
Claimant`s Phone #:
Please provide the other parties name:
Do you have any Claim Pictures? 
Most Carriers will require more specific information which can be provided later. We will call you upon reciept of this form. If you have not heard from us within one hour please call the office directly at 1-800-493-1886.
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