Insurance Adjusters

Insurance Adjuster Request

Please fill out the form below to request insurance service from the nearest local office to the claimant's loss address.

  • Please enter your first name.
  • Please enter your last name.
  • Please enter your email address.
    This isn't a valid email address.
  • Please enter your phone number.
  • Please enter the insurance company to invoice.
  • Please enter the insurance company address.
  • Please enter the insurance company city.
  • Please enter the insurance company state.
  • Please enter the insurance company zip code.
  • Please enter the claimant first name.
  • Please enter the claimant last name.
  • Please enter the loss address.
  • Please enter the loss city.
  • Please enter the loss state.
  • Please enter the loss zip code.
  • Please enter the claim number.
  • Please enter the date of loss.
  • Please enter the claimaint's primary phone number.
    Please make a selection.
  • Please enter your comments.

If you have questions or problems, please contact the American Leak Detection Insurance Team at insurance@americanleakdetection.com or 760-969-6833.

Required*

Privacy Policy: To answer your questions or comments, American Leak Detection only collects personal information that you voluntarily provide us with. We do not sell or share this information with any third parties outside of the ALD system.