Environmental Assignment Form

Please complete and submit the following information regarding your claim assignment or email your assignment to NewClaims@custard.com. You may also call in your assignment to our HOTLINE at 1.888.CUSTARD/1.888.287.8273

Your assignment will be sent to our HOTLINE for immediate processing.

Required fields are marked with *

For technical assistance, please contact our IT Department at 1-877-477-2223
(Monday through Friday between 8:00AM and 5:00PM Eastern)


NOTE: If this is an emergency response, please contact our Environmental Department at (866)289-3824


Location of Adjuster Assignment

Submitted By

Report To (if different from above)

Policy Information

Loss Information

Insured Information

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