request for investigation

Welcome to CorVel's request for service center and we thank you for your business. Please take a moment to complete the form below and click ‘submit'. If you have any questions our our liability or investigation services, please email liability_investigations@corvel.com or call (858) 300-2543.

*Type of Investigation Requested (check all that apply)**
Insured StatementPhotos/DiagramWitness StatementClaimant Statement Police ReportMediationMSCOther
Requested Due Date: *		Rush:

Client Information
Claim Number:	*	Address:	*
Claims Examiner:	*	Address 2:
Company:	*	City:	*
Email:	*	State:	*
Phone:	*	Zip:	*

Counsel Information
Copy to Counsel:		Address:
Defense Counsel:		City:
Attorney Name:		State:
Attorney Phone:		Zip:

Additional Information

Auto & Liability

Auto & Liability

request for investigation