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Envista has discontinued its domestic UK engineering services. For inquiries related to incidents occurring in North America, Asia, Australia, or elsewhere around the globe, please visit this page to be connected with the appropriate regional team.
Envista’s global experts remain available to assist clients with complex, catastrophic, or multinational losses occurring around the world, providing responsive, high-quality service wherever it is needed.
Client Information
Claim Information
Description
Details
Review
Client Information
Name
{{firstName}} {{lastName}}
Company
{{company}}
Email Address
{{emailAddress}}
Work Address
{{addressLine1}} {{addressLine2}}
{{city}}, {{state}}{{canadianProvince}} {{postalCode}}
{{country}}
Work Phone Number
{{phoneNumber}}
Job Title
{{jobTitle}}
Billing Address
{{billingFirstName}} {{billingLastName}}
{{billingAddressLine1}} {{billingAddressLine2}}
{{billingAddressCity}}, {{billingAddressState}}{{billingCanadianProvince}} {{billingAddressPostalCode}}
{{billingAddressCountry}}
Claim Information
Claim Number
{{claimNumber}}
Date Of Loss
{{dateOfLoss}}
Claim Amount
{{claimAmount}}
Insured's Name
{{insuredsName}}
Insured Contact Name
{{insuredContactFirstName}} {{insuredContactLastName}}
Insured's Phone Number
{{insuredsPhoneNumber}}
Insured's Email Address
{{insuredsEmailAddress}}
Insured's Address
{{insuredsAddressLine1}} {{insuredsAddressLine2}}
{{insuredsCity}}, {{insuredsState}}{{insuredsCanadianProvince}} {{insuredsPostalCode}}
{{insuredsCountry}}
Loss Location
{{lossAddressLine1}} {{lossAddressLine2}}
{{lossAddressCity}}, {{lossAddressState}}{{lossCanadianProvince}} {{lossAddressPostalCode}}
{{lossAddressCountry}}
Description
Description of Loss
{{briefDescriptionOfLoss}}
Scope of Work
{{whatDoYouWantUsToDo}}
Files
-
{{attachFilesInfo}}
Details
Requested Expert
{{requestSpecificExpert}}
Discuss Budget Y/N
{{discussBudgetBeforeStarting}}
First Time Using Envista Y/N
{{firstTimeUsingEnvista}}
How did you hear about us?
{{howDidYouHearAboutUs}}
How did you hear about us? (other)
{{howDidYouHearAboutUsOther}}
Client Information
Case Information
Description
Details
Review
Client Information
Name
{{firstName}} {{lastName}}
Company
{{company}}
Email Address
{{emailAddress}}
Work Address
{{addressLine1}} {{addressLine2}}
{{city}}, {{state}}{{canadianProvince}} {{postalCode}}
{{country}}
Work Phone Number
{{phoneNumber}}
Job Title
{{jobTitle}}
Billing Address
{{billingFirstName}} {{billingLastName}}
{{billingAddressLine1}} {{billingAddressLine2}}
{{billingAddressCity}}, {{billingAddressState}}{{billingAddressCanadianProvince}} {{billingAddressPostalCode}}
{{billingAddressCountry}}
Case Information
Do You Want a Sales Person To Contact You?
{{salesPersonContact}}
Is a case being submitted?
{{submittingACase}}
Parties Involved
{{partiesInvolved}}
Case
{{caseInfo}}
Loss Address
{{lossAddressLine1}} {{lossAddressLine2}}
{{lossAddressCity}}, {{lossAddressState}}{{lossAddressCanadianProvince}} {{lossAddressPostalCode}}
{{lossAddressCountry}}
Description
Description of Loss
{{briefDescriptionOfLoss}}
Scope of Work
{{whatDoYouWantUsToDo}}
Files
-
{{attachFilesInfo}}
Details
Requested Expert
{{requestSpecificExpert}}
Discuss Budget Y/N
{{discussBudgetBeforeStarting}}
First Time Using Envista Y/N
{{firstTimeUsingEnvista}}
How did you hear about us?
{{howDidYouHearAboutUs}}
How did you hear about us? (other)
{{howDidYouHearAboutUsOther}}
Client Information
Claim Information
Carrier Information
Description
Details
Review
Client Information
Name
{{firstName}} {{lastName}}
Company
{{company}}
Email Address
{{emailAddress}}
Work Address
{{address1}} {{insuranceAdjuster_address2}}
{{city}}, {{insuranceAdjuster_state}}{{canadianProvince}} {{postalCode}}
{{country}}
Work Phone Number
{{phoneNumber}}
Job Title
{{jobTitle}}
Billing Address
{{billingFirstName}} {{billingLastName}}
{{billingAddressLine1}} {{billingAddressLine2}}
{{billingAddressCity}}, {{billingState}}{{billingCanadianProvince}} {{billingAddressPostalCode}}
{{billingAddressCountry}}
Claim Information
Claim Number
{{claimNumber}}
Date Of Loss
{{dateOfLoss}}
Claim Amount
{{claimAmount}}
Insured's Name
{{insuredsName}}
Insured Contact Name
{{insuredContactFirstName}} {{insuredContactLastName}}
Insured's Phone Number
{{insuredsPhoneNumber}}
Insured's Email Address
{{insuredsEmailAddress}}
Insured's Address
{{insuredsAddressLine1}} {{insuredsAddressLine2}}
{{insuredsCity}}, {{insuredsState}}{{insuredsCanadianProvince}} {{insuredsPostalCode}}
{{insuredsCountry}}
Loss Location
{{lossAddressLine1}} {{lossAddressLine2}}
{{lossAddressCity}}, {{lossAddressState}}{{lossCanadianProvince}} {{lossAddressPostalCode}}
{{lossAddressCountry}}
Carrier Information
UMR (Unique Market Reference)
{{lloydsUMR}}
UCR (Unique Claim Reference)
{{lloydsUCR}}
OSND (Original Signing Number and Date)
{{lloydsOSND}}
Order (% of responsibility)
{{lloydsOrder}}
Lloyd’s lead (Lead syndicate on the policy)
{{lloydsLeadSyndicate}}
UW contact (Underwriter contact)
{{lloydsUWContact}}
Description
Description of Loss
{{briefDescriptionOfLoss}}
Scope of Work
{{whatDoYouWantUsToDo}}
Files
-
{{attachFilesInfo}}
Details
Requested Expert
{{requestSpecificExpert}}
Discuss Budget Y/N
{{discussBudgetBeforeStarting}}
First Time Using Envista Y/N
{{firstTimeUsingEnvista}}
How did you hear about us?
{{howDidYouHearAboutUs}}
How did you hear about us? (other)
{{howDidYouHearAboutUsOther}}
Client Information
Description
Review
Client Information
Name
{{firstName}} {{lastName}}
Company
{{company}}
Email Address
{{emailAddress}}
Work Address
{{addressLine1}} {{addressLine2}}
{{city}}, {{state}}{{canadianProvince}} {{postalCode}}
{{country}}
Work Phone Number
{{phoneNumber}}
Job Title
{{jobTitle}}
Billing Address
{{billingFirstName}} {{billingLastName}}
{{billingAddressLine1}} {{billingAddressLine2}}
{{billingAddressCity}}, {{billingAddressState}}{{billingCanadianProvince}} {{billingAddressPostalCode}}
{{billingAddressCountry}}
Description
Description of Loss
{{briefDescriptionOfLoss}}
Scope of Work
{{whatDoYouWantUsToDo}}
Files
-
{{attachFilesInfo}}
How did you hear about us?
{{howDidYouHearAboutUs}}
How did you hear about us? (other)
{{howDidYouHearAboutUsOther}}
Thank You!
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