Lotus Insurance Solutions, LLC
Vehicle Appraisal

  • Please provide as much information about the claim as possible
  • Required fields are marked by the symbol
  • If you do not have the information for a required field, please enter "unknown"
  • Claim Details and Assignment Type
    response required Loss Date
    response required Claim #
    response required Policy #

    Insured First Name      Insured Last Name  
    Insured Telephone  

    response required Brief Description of Loss 
    response required General Assignment Instructions 
    Loss Location Information
    Address City State Zip Code
    Client Information/Reporting Address
    response required Client Company Name
    response required First Name
    response required Last Name
    Mailing Address
    Building/Suite
    City
    State
    Zip
    response required Phone #
    Fax #
    response required E-Mail 
    Vehicle #1 Informtion
    response required Owner of Vehicle 1  Insured Claimant
    response required Owner's First Name
    Middle
    response required Last Name
    Company Name
    Address 1
    Address 2
    City
    State
    Zip
    response required Phone #
    Other Phone #
    Fax #
    response required Location/POI/Damage 
    response required Notes/Special Instructions 
    response required Vehicle Type
    response required Vehicle Make
    response required Color
    response required Yr
    response required Model
    response required VIN
    response required Plate
    response required Driveable?
       Yes    No
    response required Are there additional vehicles to report?   Yes    No