Insurance Claim

Need to make an insurance claim with the City of Sedalia? Use the form below to start a claim online. Don't hesitate to contact us with any questions.

Insurance Claim Form

Name(Required)

First Last

Phone(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date of Incident(Required)

Time of Incident(Required)

Location of Incident(Required)

Please describe specifically the nature of the claim.(Required)

Are estimates for the repair(s) available?(Required)

Yes

Please upload a PDF(s) of the estimates for repair.(Required)

Drop files here or

Accepted file types: pdf, Max. file size: 50 MB, Max. files: 3.

Signature(Required)

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Comments

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