NTI Claims Counsel

Use this form during or immediately after speaking with a client who has reported a claim. Goal: Support, educate, advocate, and document.

  • Initial Claims Contact & Details

  • If applicable.
  • Which policy are we looking at? Either type of policy (Auto, Home, Business) or policy number.
  • What was the date the incident happened?
    If another party was at fault, and they have insurance, we encourage to contact their insurance to start the claim process. *This can avoid having to pay a deductible and/or wait for reimbursement.
  • Add the details of the request.
  • If there was a police report filed, include the report or incident number.
  • Were there any injuries?

  • NTI Initial Claims Counsel

  • Note the deductible and YES, NO or NA
  • Note anything specific - or YES, NO, NA. We will connect the client to their insurance carrier to give a recorded statement. An adjuster will be assigned within 24-48 hours and will be the authority of the claim going forward. Use the mobile app or text option with adjuster when possible, this can expedite the process. If any issues come up, please let us know.
  • Note anything specific - or YES, NO, NA

  • Special Attention / Red Flags

  • Next Steps / Follow Up

  • What is the timeframe they can expect to hear from us? *Use our template: End of Day (EOD) - June 6 (Date)
  • What is the preferred contact method that we'll reach out? To avoid phone tag, we'll start with email or text and go from there.
  • If the phone number or email are different than what we have on file, or need to be clarified, please include here.
  • Max. file size: 98 MB.
    Attach any related documents or emails.
  • Who is filling out this form?
  • *Client confirmation is currently turned off* Please add the email address we can send confirmation of this request.
Call or Text Email Claims Payments