Name: Contractor's Choice Agency
Address: 12220 E Riggs Rd, Chandler, AZ, 85249, US
Telephone: 844-967-5247
Price range: $$

Important Claim Reporting Information

Report claims immediately - Most carriers require notification within 24-48 hours

Emergency claims: Call 844-967-5247 for immediate assistance

Secure submission: This form sends encrypted information directly to our claims team

Claim Information Form

Please provide as much detail as possible to help us process your claim quickly

Contractor Information

Business/Contractor Name *

Phone Number *

Email Address *

Policy Number

Claim Information

Type of Claim *

Date of Incident *

Time of Incident

Location of Incident *

Description of Incident *

Claimant Information

(Person filing the claim)

Claimant Full Name *

Claimant Phone *

Claimant Email

Street Address *

City *

State *

ZIP Code *

Additional Claim Details

Injury Description (if applicable)

Property Damage Description

Witness Information

Police Report Information

Additional Information

By submitting this form, you consent to CCA processing this claim information and sharing it with your insurance carrier.

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What Happens After You Submit Your Claim?

1

Immediate Review

Our claims team reviews your submission within 2 hours during business hours

2

Carrier Notification

We immediately notify your insurance carrier and provide all claim details

3

Follow-up Contact

You'll receive confirmation and next steps from both us and your carrier

Report an Insurance Claim

Important Claim Reporting Information

Claim Information Form

Need Immediate Help?

Direct Email

What Happens After You Submit Your Claim?

Immediate Review

Carrier Notification

Follow-up Contact

Report an Insurance Claim

Important Claim Reporting Information

Claim Information Form

Contractor Information

Claim Information

Claimant Information

Additional Claim Details

Need Immediate Help?

Direct Email

What Happens After You Submit Your Claim?

Immediate Review

Carrier Notification

Follow-up Contact

Contractor Information

Claim Information

Claimant Information

Additional Claim Details