Trover Solutions, Inc.

TransPaC Solutions

Property & Casualty Claims Referral Form

Clients of TransPaC Solutions can use this online form to refer claims directly to a TransPaC representative.

Trover Plaza | 9390 Bunsen Parkway | Louisville, KY 40220

PLEASE NOTE: Because the information you submit is not currently being encrypted and its privacy cannot be guaranteed by Trover Solutions, we recommend that you strongly consider not using this means of communication for matters that are of a confidential nature.

Subrogation Recovery Assignment:

* are required fields

Client: *
Client Number: *
Company: *
Adjuster: *
E-Mail: *
Telephone: *
Date Assigned: *
Policy Holder: *
Policy Number: *
Claim Number: *
Date of Loss: *
Statute Runs: *
Loss State: *
Loss Description: *
Evidence Retained?: *
Employee Name: *
Type of Claim (i.e. - Workcomp, Auto, Property): *

3rd Party Information

Name:
Address:
Telephone Number:
Driver's License Number:

3rd Party Insurance Information

Company Name:
Telephone Number:
Telephone Extension:
Address:
Adjuster:
Named Insured:
Claim Number:

Attorney Involvement:

Name:
Representing:
Was a report taken?
Yes
No
Type of Report:
Total Lien to Date:
Coverages Paid:
Amount Recovered to Date:
Coverage(s) Remaining Open:
Any Known Related Facts:

Available Documents Online:

1 - Report of Loss
2 - Police Report
3 - Payment Screen
4 - Appraisal
5 - Denial Letter From Advance Insurance

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