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Client Support

Independent Insurance Agents of Texas

Houston Agencies, Inc.
211 Highland Cross Suite 260, Houston, TX, 77073
Phone: (281) 443-0333
Toll Free: (800) 317-3120
Fax: (281) 443-4452
Email Us

Claim Form

Your Name:

First	Last

Email Address:

Phone Number:

5 Digit Zip:

Policy Number:
Date of Loss:
Time of Loss:
Location of Incident/Loss:
Description of Incident/Loss:
Were the Authorities Called?
Additional Information:

By clicking submit, I understand this is not an actual claim, but notification to my agent to help with the process of my claim.

Note: By submitting this form you understand that no coverage is bound until you receive written notice. You also agree to release us from any liability if this information is accidentally viewed by unauthorized persons. We will only use this information for insurance quoting purposes and not distribute to other parties.