Gemcor Claims and Salvage  
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Submit a Claim
To: Gemcor Claims Specialist       Fax: (800) 432-3282
     
FROM:    
Adjuster (First & Last name):  
Insurance Company:  
Mailing Address:  
     
Phone:  
Fax:  
Email:  
     
Would you like a
confirmation of receipt? 		 

     
REGARDING:    
Your claim number:  
Name of Insured:  
Insured's Home Phone:  
Insured's Work Phone:  
     
Insured's Address:  
     
Policy Limit:      
Deductible:  
     
Description of Loss:
(and please fax any
corresponding appraisal
information):		  
     
   



 

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