Client Access
Make a Payment
6785 Telegraph Road, Suite 400
Bloomfield Hills, MI 48301
(877) 454-3400
Home
About
Technology
Services
Arbitration Management
Auto, Property, Workers Compensation
Appraisal
Co-Sourcing
Desk Review
First Notice of Loss
Forensic Audit
Informational Videos
Litigation Management
Outsourcing
PD Subro Review
Salvage Administration
Self-Insured & Carrier Programs
Specialty Risk Programs
Subrogation Purchase
News
Contact
Careers
Resources
Claim Referral Form
Salvage Referral Form
Statute Guide
Useful Links
Client Access
Make a Payment
Videos
Salvage Referral
Conveniently refer Salvage Information to Latitude Subrogation Services.
//
Adjuster/Reporting Party
Claims Adjuster
Primary Phone
Company Name
Email Address
//
Loss Information
Insurance Company
Insured Name
Claim Number
Date of Loss
State/Providence
Policy Number
Salvage Vehicle is for:
Select...
Insured
Claimant
//
Owner
Name
Address
City
State/Providence
Postal Code
Phone
Email
//
Lienholder
Name
Address
City
State/Providence
Postal Code
Phone
Account #
Letter of Guarantee Obtained
Select...
Yes
No
//
Vehicle Information for Salvor Pickup Assignment
Salvor Information
Pickup Request
Select...
Yes
No
Salvor Already Assigned
Select...
Yes
No
Name of Salvor Assigned
Approval to Pay Charges
Select...
Yes
No
Salvor Lot #
Vehicle Information
Year
Make
Model
VIN #
Color
Police Report in File
Select...
Yes
No
ACV
$
USD
CAN
Repairs
$
USD
CAN
Owner Retained Fee
$
USD
CAN
Theft
Select...
Yes
No
Owner Retained
Select...
Yes
No
Loss Estimate in File
Select...
Yes
No
Pickup Location
Name
Address
City
State/Providence
Postal Code
Phone
Brief Loss Description
//
Special Handling Instructions/Comments
//
Attach File(s) (Optional)
Step 1
Step 2
Files Attached:
Submit
© 2024 Latitude Subrogation Services |
Privacy Policy
|
Legal Notices
6785 Telegraph Road, Suite 400
Bloomfield Hills, MI 48301
(877) 454-3400