Insurance Information

FFAM ID Number *

This is the 7 digit FFAM File Number.

How to Locate your FFAM ID Number

The FFAM ID Number is located on the letter you received from FFAM directly. It is listed as Our Account # on the letter as shown here.

Phone Number *

Phone Number we may reach you at with any Questions we have

Policy Holder Name *

The Policy Holders Name

Insurance Company Name *

The name of your Insurance Company

Policy Number *

Your Policy Number as it appears on your Policy

Policy Period *

The starting and ending date of your Policy

Claim Number

Claim Number received from your Insurance Company

Adjuster Name

The name of your adjuster

Adjuster Phone Number

The phone number of your Adjuster

Adjuster Fax Number

Your Adjusters Fax number if you received one

Your Preferred Email Address *

Your email address. A copy of this form will be sent to your email address given here


Authorization to correspond using email address above
I authorize FFAM to correspond with me using the email address above

Upload File

You may upload insurance infomation or documents here


Please select a number between 30 and 50 *