After The Fact Private Investigation Agency

Online Contact Form

Insurance Claim Case Information Request

Please fill out the following form as completely as possible. You will be contacted by After The Fact within 2 business days.

Claimant Information
Claimant’s Name:
Home Address:
City State Zip:
Home Phone:
Work Address:
City State Zip:

Work Phone:

 ext.
Claim Data
Claim #:
Date of Loss:
Location of Loss:
Adjuster:
Investigator:
Type of Claim:
Description of Injury and Restrictions:
Medical Aids:
Doctor Appointments:
Hearing Dates:
Vehicle Descriptions:
Claimant Demographics
Habits:
Hobbies:
Hang-outs:
Attachments
Database searches:
Claim file information:
Prior surveillance reports: