Home Insurance Claim Form

First Name

Last Name

Date of Birth (DD/MM/YYYY)

House No. & Street Address

Address Line 2

City

Zip/Postal Code

Email Address

Phone Number

LS Claims Ltd T/A Ingram Toft, authorised and regulated by the Financial Conduct Authority (FCA) for regulated claims management services. Our firm reference number is: 831386. You can check this on Financial Services Register at https://register.fca.org.uk. For more information, please visit our website: www.ingramtoft.co.uk