Submit a Claim

Golden State Claims Adjusters is an industry leading Third Party Administrator in the professional management, administration and handling of claims in the commercial general liability and surety fields. Our knowledgeable, skilled and dedicated staff will use their experience, specialized knowledge and industry awareness to obtain the best possible results for your claims requirements.

Best Practices

Claims Handling Expectations
Coverage Analysis
Contact & Investigation
Damages, Evaluation & Reserving
Litigation Management
Negotiation & Resolution

Once you complete the claim report we will send you a confirmation email. A third party claim examiner will call you within 48 hours to explain the next steps and confirm the details. This examiner will also be able to answer any questions you may have.

(866) 472-7662
claims@gstateca.com
goldenstateadjusters.com

Policy Information
Policy Number*
Today's Date*
MM slash DD slash YYYY
Date of Loss*
MM slash DD slash YYYY
Insured Information
Insured Contact Name*
Insured Contact Email*
Insured Contact Phone*
Insured Contact Address*
Street Address City State ZIP Code

Description of Loss
Location of occurrence including city and state*
Description of loss*
Claim Information Documents
Drop files here or

Accepted file types: pdf, doc, docx, odt, png, jpg, jpeg, Max. file size: 20 MB.
Date Work Started*
MM slash DD slash YYYY
Date Work Completed*
MM slash DD slash YYYY
Scope of Work*
Insured Contractor License Number*
Claimant Information
Claimant Name*
Claimant Email*
Claimant Phone*
Claimant Address*
Street Address City State ZIP Code

Submit a Claim

Policy Information

Insured Information

Description of Loss

Claimant Information

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