Rhode Island Independent Insurance Agent - Revens-Gates, Inc. Insurance

401-294-9537

Homeowners Claim Information

To submit a claim directly to us, please complete the following form and click "Submit"

Home Claim Form

Contact Person Name
Contact Contact Phone
Contact E-mail

Policy Number
Policy Holder Name
Policy Holder Street Address
Policy Holder City
Policy Holder State, ZIP	ZIP
Date of Loss:
Click here if Loss Location address is the same as Policy Holder address
Loss Location Street Address
Loss Location City
Loss Location State, ZIP	ZIP
Brief description of loss:
Did injuries result from loss?	yes no

Thank you for your claim submission. We will process it as soon as possible and will contact you to confirm our reciept of your claim.