Submit Assignment | Midwest Ladder Assis

top of page

MLA - 2_edited.jpg

Home
Submit Assignment
Our Team
More

Use tab to navigate through the menu items.

Submit a Claim Assignment

Please take a moment to fill out the form.

Carrier (Company) Name

Claim Number

Adjuster Name

Adjuster Phone Number

Adjuster Email

Insured Name

Insured Phone Number

Insured Address?

Choose your inspection requests (select more than 1 if applicable for the claim): * Required

Exterior Inspection (Roof & Elevations)

Roof Measurement Report (Hover)

Mitigation (Tarp Roof)

Ladder Assist Only

Interior Inspection

Xactimate Estimate (*For Reference Only)

Additional inspection details?

Thanks for submitting!

mwladderassist@gmail.com

©2023 by MidWest Ladder Assist. Proudly created with Wix.com

bottom of page