Florida Public Adjuster Contract and Policyholder Form

Florida Public Adjuster Contract/Service Agreement and Policyholder Information Forms are essential for your Public Adjuster. D’Orsa and Associates, LLC Public Adjusters want to support you in the optimal approach possible. The more information we have from the start of the process, the better we will be able to manage your claim to achieve the best possible results for you, the policyholder.

In order to process your insurance claim punctually and judiciously the following documents are valuable and crucial (to your Public Adjuster) when filing and presenting an insurance claim.

Please provide the following information and data for your Public Adjuster:

Name of all insured(s)
Address where damage occurred
Mailing address
Telephone number(s), cellular, home and work
Electronic mail address
Insurance company name and address
Policy number
Claim number (if already assigned). If you do not have a claim number, we will file the claim for you. Thus, we will need from you: The description of loss to include cause of loss; time and date of loss; location of incident; description of damage.
Policy declaration page and accompanying insurance policy (if you have the policy).
Mortgage number and/or home equity loan number or other encumbrances (such as IRS liens) on damaged property (include contact information and loan number)
Authority notification(s) such as fire department, police department, emergency service companies and/or damage mitigation Previous claim or loss information
Any and all documents/correspondence relating to the current claim Photographs of the damage; and before and after pictures (if you have them).
Your assigned Public Adjuster will also be taking several photographs of the damaged property.
Any home inspection or appraisal reports

You may complete our Policyholder Information Form. You may complete the Florida Public Adjuster Contract. Florida Public Adjuster Contract. The Public Adjuster service agreement must be signed by all insured(s) named on the policy. You may fax your documents to (855) 742-3587 or you may scan and upload the documents on the contact page on our website or electronically scan and mail the documents and/or pictures to adjuster@dorsaassociates.com.


D’Orsa and Associates, LLC Public Adjusters look forward to helping you fully recover from your loss.

Thank you.