Transportation 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 *

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(Monday through Friday between 8:00AM and 5:00PM Eastern)




Submitted By

Report To (if different from above)

Policy Information

Loss Information

Insured Information

Insured Vehicle Information

Claimant Information # 1

Claimant Vehicle Information # 1

Witness Information

Policy in Force

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