In order to report a Claim, click here for 2021 Sworn Statement proof of loss which must be completed, signed and returned to Haylor, Freyer & Coon, Inc.
The 2021 Sworn Statement proof of loss can be returned 3 ways:
1. Via email to firstname.lastname@example.org
2. Via fax at (315) 362-5733
3. Via mail, at :
Haylor, Freyer, & Coon, Inc.
P.O. Box 4743
Syracuse, NY 13221
To prevent a delay in settlement we request that you submit your claim form within 90 days of the date of loss. If you are going to Email the completed form to us, please include the words “Insurance Claim” on the subject line to ensure your message is not caught by our SPAM Filter.
Required Documentation To Include with the 2021 Sworn Statement proof of loss
· A copy of the receipt or the original bill for the damaged or stolen items. If this information is not available, we require written estimate from the place of purchase (or similar store) for the same or comparable items. We also accept website documentation to determine value.
· For Claims involving theft or vandalism, a Security or Police report is required.
· For Accidental Damage to electronic items valued over $500 a repair estimate or bill is needed. If the item is not repairable, then we will need a statement from an authorized repair facility.
Disclaimer: We must advise that any person who knowingly and with intent to defraud any insurance company or other person files a statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime.