Client Information

To assist us with our transition to becoming paperless, from this point forward, please send any new assignments to us via these following methods

E-mail us:	claims@norfieldassociates.com
Visit our website:	http://www.norfieldassociates.com
Telephone us:	877-293-4682

We also ask that any communication with our employees be done via e-mail to their individual e-mail address, which is determined by using their first initial, last name and then @norfieldassociates.com. For example, in order to send me an e-mail, please direct it to me at chenrichon@norfieldassociates.com.

In the event that you need to speak with an employee, please contact them at the appropriate direct dial telephone number for them.

In the event that you need to send us something via regular mail, please send it to us at

Norfield Associates, Inc.
P. O. Box 319
Topsfield, MA 01983

In the event that you need to send us something via facsimile, please fax it to: 978-279-1069

Once it has been received, we will scan it and send it to the appropriate party.

CLIENT INFORMATION

Company Name
Street Address
City
State
Zip Code
Contact and Title
Email Address
Telephone #

POLICY INFORMATION

Your Claim Number
Policy Number
Effective Dates of the Policy
Policy Limits

INSURED INFORMATION

Insured Name
Address
City
State
Zip Code
Home Telephone Number
Work Telephone Number
Cellular Telephone Number
Insured Operator Name (if applicable)
Insured Operator Address
City
State
Zip Code
Home Telephone Number
Work Telephone Number
Cellular Telephone Number
Insured Vehicle
Vehicle Registration Number
Damage
Estimate of Repair
Date of Birth
Were they injured?

LOSS INFORMATION

Date of Loss
Time of Loss
Location of Loss; City, State, Zip Code
Briefly Describe the Loss

CLAIMANT/INJURED PARTY INFORMATION:

Name
Address
City
State
Zip Code
Home Telephone Number
Work Telephone Number
Cellular Telephone Number
Claimant Attorney Name
Address
City
State
Zip Code
Telephone Number
Claimant Vehicle
Vehicle Registration Number
Damage
Estimate of Repair
Date of Birth
Injuries
Medical Provider Name
Street Address
City
State
Zip Code
Telephone Number
Adverse Carrier Name and Telephone Number
Adverse Carrier Claim/Policy Number

OTHER INFORMATION

Are there any Witnesses to the Loss?
Witness Name
Address
City
State
Zip Code
Home Telephone Number
Work Telephone Number
Cellular Telephone Number

PLEASE INCLUDE THE INVESTIGATION YOU WOULD LIKE US TO CONDUCT
Please e-mail any supporting documentation to us at claims@norfieldassociates.com
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