EMS Form

Insured's Information
First Name
Last Name


Phone Number

Secondary Phone Number

Project Type  

Claim Number
Severity Level

Wind 1 -    No information available, insured has not seen the house, but knows there is damage. Needs FEMA letter only.  Loss of Use only. Food spoilage only.

Wind 2 -    Minimal damage to detached structures, contents damage only, some damage to roof.

Wind 3 -    Damage to roof, missing shingles/tiles/metal with some interior water damage, but dwelling is still livable.

Wind 4 -    Heavy structural damage to roof, framing, with heavy interior water damage, collapsed walls, ceilings. Dwelling is not livable or dwelling is a total loss.

Additional Details

Claim Type