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File A Claim

File a Claim

If you experienced damage/loss to any of your household items due to an outage, please complete the online web form below.

Member Name

Member E-mail

Member Phone #

Member Account #

Date of Loss

This is the date when the outage occurred.

Mailing Address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Outage Address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Please provide the address or area where the outage occurred.

Description

Please provide a detailed account of what took place, as well as, an itemized list of what was lost/damaged along with estimated value(s).

Supporting Document

If you have receipts or any other information you can provide us, please upload.
Upload requirements

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.