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905-495-8282
83 Mill Street, Suite 304, Georgetown, ON L7G 5E9
About Delta
TEAM DELTA
SUSTAINABILITY
Insurance Investigations
SUBMIT INSURANCE ASSIGNMENT
Locate/Skip trace and Asset Investigations
SUBMIT A LOCATE / SKIP TRACE ASSIGNMENT
ASSET INVESTIGATIONS
Corporate Investigations
SUBMIT CORPORATE ASSIGNMENT
Employment
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Insurance Assignment
Insurance Assignment
Please fill out the form below to submit an Insurance Assignment
Assigned By (required)
Company: (required)
Phone (required)
Your Email (required)
Type of Claim
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Bodily Injury
Accident Benefits
Life & Health
Other
Claim Number: (required)
Named Insured: (required)
Date of Notice: (required)
Expense Limit (Inclusive of Taxes): (required)
Subject Information
Date of Loss:
Subject
Date of Birth:
Drivers License Number:
Address 1:
Address 2:
Address 3:
Home Phone:
Cell Phone:
Work Phone:
Family Members:
Attach any Relevant Reports
Vehicle Information
Vehicle Make and Model:
License Plate:
Employment Information
Employer:
Employer Address:
Employer Phone:
Occupation:
Return to Work (required):
Yes
No
Unknown
Additional Information
Lawyer:
Lawyer Phone:
Treatment Facilities:
Assignment Information
Injury / Loss Details:
Comments:
Investigation Required:
Submit
Insurance Assignment
Submit
Locate / Skip Trace Assignment
Submit
Individual / Corporate Asset Assignment
Submit
Corporate Assignment
Phone: 905-495-8282
Toll Free: 1-877-402-0220
info@deltainvestigations.ca
83 Mill Street
Suite 304
Georgetown, ON L7G 5E9
8:30 AM - 4:30 PM
Monday to Friday