Assign A Case

Forensic Business Solutions, Inc.

Professional Personal, Business and Insurance Solutions

Assign A Case

New Case Assignment Form

Please complete the form below and click submit to assign a new case. You will receive an acknowledgment via e-mail within 24 hours. if you do not, please contact our office to confirm our receipt of your assignment. You may fax any supporting documentation to us at 401-782-3817.

Company Name:
Your Name:
Mailing Address:
Telephone & Extension:
Fax Number:
E-Mail:
Your Claim Number:
Date of Loss:
Location of Loss:
Description of Loss:
Insured Name, Address & Phone:
Insured Attorney Information:
Claimant #1 Name, Address & Phone:
Claimant #1 DOB:
Claimant #1 SSN:
Claimant #1 Attorney Information:
Claimant #2 Name, Address & Phone:
Claimant #2 DOB:
Claimant #2 SSN:
Claimant #2 Attorney Information:
Witness Information - Name, Address, Phone:
Additional Case Information:
Please State Your Specific Case Handling Instructions: