Submit A Claim

**If you are a first time user, please fill out the form below to submit a claim. A representative will contact you shortly to set you up in our system.

Adjuster Information
Name:*
First Last
Company Name:*
Office/Zone:
Supervisor Name:
Email (This will be your username)*
Phone*
Fax
Policyholder Information:
Name
First Last
State:
Zip Code*
ZIP / Postal Code
Email
Phone
Claim Information:
Claim Number:
Date of Loss:
Date Format: MM slash DD slash YYYY
Deductible:
Individual Limit:
Aggregate Limit:
Contact Insured*
- Contact Insured* (Recommended)
- Do Not Contact Insured
Replacement Items:
1. Scheduled Limit:
Item Description:
2. Scheduled Limit:
Item Description:
3. Scheduled Limit:
Item Description:
4. Scheduled Limit:
Item Description:
5. Scheduled Limit:
Item Description:

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- “Artigem recently handled the replacement of a cracked center diamond and a side diamond in my wedding band, and I wanted to express my sincere appreciation for their excellent customer care and service. During the entire process, my Jewelry Specialist was always very friendly, very easy to talk to, and kept me well informed in every step of the process. Her enthusiasm for my replacement stones (they are gorgeous!), her knowledge of the products and process, and her speedy responsiveness was top notch. I honestly can’t remember when I’ve had that level of customer care. She made the experience as pleasant as possible!”
  
  Susan, 2018
- “First and foremost, I do not like the ring…… I absolutely LOVE IT! It is so beautiful! Thank you so much for making this such an easy process. My husband and I are so grateful!”
  
  Catherine, 2018
- “Just got my ring back… fabulous job and I couldn’t be more pleased. Thank you for finding the right stone! All is right with the world.”
  
  Majorie, 2018
- “I did pick up my necklace yesterday and it’s beautiful! I am very pleased with the replacement quality of the diamonds. Thanks so much for all of your help with this process. Much appreciated! I’m so happy to have my necklace back… I just felt sick in losing it.”
  
  Diane, 2018
- “I just want to tell you, I really appreciate all your help with this. I really had no idea where I should start. You’re making it a lot easier for me to find a replacement of my precious rings!”
  
  Michelle, 2018

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Adjuster Information

Policyholder Information:

Claim Information:

Replacement Items: