Request a Loss History Report

Please provide your information. All fields are required. Personal Information Use

Policyholder Name:

Policy Number:

Using a recent bill, enter the first 15 digits of the policy number, including the dashes. Example: 103-1234567890-03

Policy Effective Date:

Where to send the Loss History:

Fax to Agency listed on policy
Mail to Agency listed on policy
Mail to Insured's address listed on policy
Mail to Lienholder listed on policy

Check at least one. For security reasons, loss history information can only be sent to contacts already listed on the policy.

Comments Area:

Contact Phone Number:

Contact Email Address:

We will only contact you if there is a question about your request.

How many persons live in your residence?

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Foremost is a proud member of the Farmers Insurance Group of Companies, offering a wide variety of home, life, specialty, commercial and auto insurance products and services across the United States. © 2019 Copyright Foremost Insurance Company

Foremost Headquarters - 5600 Beech Tree Lane Caledonia, MI 49316

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