Report a Claim (First Notice of Loss) — Update / setup form (auth-only) for Insurance. Embeddable version — a transparent, chrome-free form that floats over your own website design (pair with the standalone version for a hosted page).

A first notice of loss so we can open your claim and connect you with the right adjuster. This is a loss report for our records, not a coverage determination — in an emergency, call 911 first.

What it collects (by section):

• What happened — What happened (summary) [long text]; Date of loss (if known) [date].
• Policy & line — Line(s) involved [multi-select: Auto (personal) / Homeowners / Renters / Umbrella (personal) / Life / …]; Location of loss (if a property) [long text]; Vehicle(s) involved (if auto) [long text]. Which coverage this relates to — references only, never policy numbers.
• Parties & evidence — Other parties involved (names only) [long text]; Injured parties / claimants (names only) [long text]; Police / incident report reference (if any) [long text].
• How to reach you — Claims Support Preference [dropdown: Phone / Email / Portal / Messaging app]; After-Hours/Emergency Contact Preference [dropdown: Call / SMS / Email / Any].

Required: What happened (summary) (kept low-friction).

Form type: Update / setup (up), auth-only. Niche: Insurance. Deployment: embed.

Best for / surface when: Insurance client workflow — report a claim (first notice of loss).