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 Property Loss Notice 
Form: Property Loss Notice
Property Loss Notice




Contact Information
Your Full Name:
(as listed on policy now)
Your Email Address:
Daytime Telephone Number:
Description of Loss
Time & Date of Loss:
 Time AM PM
Date
Location:


Description of Loss:
Police or Fire Department:
Notified?
 Yes No
If Yes, Please Specify:

Is Property Habitable?:
 Yes No
If No, Where Are You Staying:
or Planning to Stay?
(Please include Address &
Telephone #'s you can be reached at):
Mortgagee or Bank Information

Please Note: Submitting this form via the website does not constitute a "formal" claim. Please contact us or your insurance company to notify of a loss.

Enter the security code you see above. Code is NOT case sensitive.*
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We currently provide insurance services in: 
  • North Carolina
  • South Carolina
  • Virginia

    Please note: Changes to policies via this website are not effective or binding until you, or any party involved, receive official notification from your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

    First Casualty Insurance Group, Inc.
    190-A Turner Street
    Southern Pines, NC 28387
    1-800-352-3416
    fciginfo@fcignc.com
     
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