Damage / Loss Claim
Please fill out form below as accurate and as detailed as possible for a quick process.
Type of move: (Please be sure to pick correct one to avoid re-submitting claim)
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Residential (Items were placed in Swift Movers Truck)
Load Only (Truck was loaded that was not Swift Movers')
Commercial/Business (Move was for business purposes)
Unload Only (Swift Movers only unloaded a truck)
Shuffle (Move items within a location with no truck needed)
Full Name
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First Name
Last Name
Mailing Address:
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Phone Number
Email
*
example@example.com
Date of Move:
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Month
-
Day
Year
Date
Date of Claim made (Today)
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Month
-
Day
Year
Date
If more than one item, please only describe one item at a time.
First Item: damage / loss (Description)
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First Item: Estimated dimensions and weight of items:
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First item was (Select all that apply.)
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Packed before movers arrived
Packed by Movers
Movers had no proper packing material available
Item barley fit through pathway
Wall/floor protected before movers arrived
Wall/floor protected by movers (Materials needed before arrival)
Second damage / loss (Description)
Second Item: Estimated dimensions and weight of items.
Second item was (Select all that apply.)
Packed before movers arrived
Packed by Movers
Movers had no proper packing material available
Item barley fit through pathway
Wall/floor protected before movers arrived
Wall/floor protected by movers (Materials needed before arrival)
Third Item damage / loss (Description)
Third Item: Estimated dimensions and weight of items.
Third item was (Select all that apply.)
Packed before movers arrived
Packed by Movers
Movers had no proper packing material available
Item barley fit through pathway
Wall/floor protected before movers arrived
Wall/floor protected by movers (Materials needed before arrival)
Forth item damage / loss (Description)
Forth Item: Estimated dimensions and weight of items.
Forth item was (Select all that apply.)
Packed before movers arrived
Packed by Movers
Movers had no proper packing material available
Item barley fit through pathway
Wall/floor protected before movers arrived
Wall/floor protected by movers (Materials needed before arrival)
Fifth Item damage / loss (Description)
Fifth Item: Estimated dimensions and weight of items.
Fifth item was (Select all that apply.)
Packed before movers arrived
Packed by Movers
Movers had no proper packing material available
Item barley fit through pathway
Wall/floor protected before movers arrived
Wall/floor protected by movers (Materials needed before arrival)
Desired wishes and comments
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I hereby verify the above information is true and understand that a false statement can result in a denial of claim.
Job #
Shipper has been informed and understand policy?
Yes
No
Claim report with next action needed:
Total paid (Not paid in full is automatic denial.)
Job Sourc:
Crew Leader:
*
Other Movers on site: (First name and last initial on each line)
Weight and dimensions Verified:
Dispatch Notes to go onto Movers report (Include movers name to help movers remember)
All signatures on contract have proper signatures
yes
no
partial
Contract indicate type of liability/Coverage:
No liability, No Coverage
$1 per pound per article
Red Level full coverage replacement
Type of Coverage purchased before move:
Released Value (Free) $1 per pound per item
In House Coverage ($10 for $100 deductible)
Full Value Protection (Red Level - Must pay before move depending on weight)
Reasons for denial or partial denial:
Unpackage /Improper Packing
Unusual items or unusual pathways/circumstances.
No Coverage / Labor Only Services
Pre-Existing Damage.
3rd party help involved / Multiple directors
Assembly - Disassembly (Incomplete hardware or unusual hardware)
No inventory taken prior to move
Inconsistent statements
Hostile Environment
Work Hazards
No Additional coverage purchased
Settlement Offer
Shipper Happiness /understanding of settlement?
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