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Company Information
Account Information
Billing Contact Name*
- First Last
Company*
Billing Contact Email*
Address*
- Street Address
- Address Line 2
- City
- State / Province / Region
- ZIP / Postal Code
- Country
- Afghanistan
- Albania
- Algeria
- American Samoa
- Andorra
- Angola
- Anguilla
- Antarctica
- Antigua and Barbuda
- Argentina
- Armenia
- Aruba
- Australia
- Austria
- Azerbaijan
- Bahamas
- Bahrain
- Bangladesh
- Barbados
- Belarus
- Belgium
- Belize
- Benin
- Bermuda
- Bhutan
- Bolivia
- Bonaire, Sint Eustatius and Saba
- Bosnia and Herzegovina
- Botswana
- Bouvet Island
- Brazil
- British Indian Ocean Territory
- Brunei Darussalam
- Bulgaria
- Burkina Faso
- Burundi
- Cabo Verde
- Cambodia
- Cameroon
- Canada
- Cayman Islands
- Central African Republic
- Chad
- Chile
- China
- Christmas Island
- Cocos Islands
- Colombia
- Comoros
- Congo
- Congo, Democratic Republic of the
- Cook Islands
- Costa Rica
- Croatia
- Cuba
- Curaçao
- Cyprus
- Czechia
- Côte d'Ivoire
- Denmark
- Djibouti
- Dominica
- Dominican Republic
- Ecuador
- Egypt
- El Salvador
- Equatorial Guinea
- Eritrea
- Estonia
- Eswatini
- Ethiopia
- Falkland Islands
- Faroe Islands
- Fiji
- Finland
- France
- French Guiana
- French Polynesia
- French Southern Territories
- Gabon
- Gambia
- Georgia
- Germany
- Ghana
- Gibraltar
- Greece
- Greenland
- Grenada
- Guadeloupe
- Guam
- Guatemala
- Guernsey
- Guinea
- Guinea-Bissau
- Guyana
- Haiti
- Heard Island and McDonald Islands
- Holy See
- Honduras
- Hong Kong
- Hungary
- Iceland
- India
- Indonesia
- Iran
- Iraq
- Ireland
- Isle of Man
- Israel
- Italy
- Jamaica
- Japan
- Jersey
- Jordan
- Kazakhstan
- Kenya
- Kiribati
- Korea, Democratic People's Republic of
- Korea, Republic of
- Kuwait
- Kyrgyzstan
- Lao People's Democratic Republic
- Latvia
- Lebanon
- Lesotho
- Liberia
- Libya
- Liechtenstein
- Lithuania
- Luxembourg
- Macao
- Madagascar
- Malawi
- Malaysia
- Maldives
- Mali
- Malta
- Marshall Islands
- Martinique
- Mauritania
- Mauritius
- Mayotte
- Mexico
- Micronesia
- Moldova
- Monaco
- Mongolia
- Montenegro
- Montserrat
- Morocco
- Mozambique
- Myanmar
- Namibia
- Nauru
- Nepal
- Netherlands
- New Caledonia
- New Zealand
- Nicaragua
- Niger
- Nigeria
- Niue
- Norfolk Island
- North Macedonia
- Northern Mariana Islands
- Norway
- Oman
- Pakistan
- Palau
- Palestine, State of
- Panama
- Papua New Guinea
- Paraguay
- Peru
- Philippines
- Pitcairn
- Poland
- Portugal
- Puerto Rico
- Qatar
- Romania
- Russian Federation
- Rwanda
- Réunion
- Saint Barthélemy
- Saint Helena, Ascension and Tristan da Cunha
- Saint Kitts and Nevis
- Saint Lucia
- Saint Martin
- Saint Pierre and Miquelon
- Saint Vincent and the Grenadines
- Samoa
- San Marino
- Sao Tome and Principe
- Saudi Arabia
- Senegal
- Serbia
- Seychelles
- Sierra Leone
- Singapore
- Sint Maarten
- Slovakia
- Slovenia
- Solomon Islands
- Somalia
- South Africa
- South Georgia and the South Sandwich Islands
- South Sudan
- Spain
- Sri Lanka
- Sudan
- Suriname
- Svalbard and Jan Mayen
- Sweden
- Switzerland
- Syria Arab Republic
- Taiwan
- Tajikistan
- Tanzania, the United Republic of
- Thailand
- Timor-Leste
- Togo
- Tokelau
- Tonga
- Trinidad and Tobago
- Tunisia
- Turkmenistan
- Turks and Caicos Islands
- Tuvalu
- Türkiye
- US Minor Outlying Islands
- Uganda
- Ukraine
- United Arab Emirates
- United Kingdom
- United States
- Uruguay
- Uzbekistan
- Vanuatu
- Venezuela
- Viet Nam
- Virgin Islands, British
- Virgin Islands, U.S.
- Wallis and Futuna
- Western Sahara
- Yemen
- Zambia
- Zimbabwe
- Åland Islands
Company Goals*
What is your company goal that ClaimWizard will help?
- Streamline claim management process
- Maximize settlement outcomes & shorten claim cycle
- Drive team accountability & easily accessible data
- Other
Company Owner Name/Email*
Company Owner Name*
- First Last
Company Phone*
Company Owner Email*
Company Website
How did you hear about ClaimWizard?*
- Attended a product demonstration
- Watched a webinar
- Watched a demo video
- Search engine
- AI suggestion
- Social media
- Industry conference/event
- ClaimWizard email
- Magazine article
- TV/News story
- Merlin Law Group webinar
- Referral
- Used in the past
- Other
How many assignable accounts do you need?*
- Up To 3 Assignables
- 4 Assignables
- 5 Assignables
- 6 Assignables
- 7 Assignables
- 8 Assignables
- 9 Assignables
- Professional (1 Account/No Staff)
Monthly Subscription Fee
Assignable Account (Pro)*
Assignable Account #1
- First Name*
- Last Name*
- Email*
Assignable Account #1 - Role(s)*
- Multiple roles can be included on the same license fee.
- Adjuster
- ALE Adjuster
- Content Adjuster
- Appraiser
- Estimator
- Loss Consultant
- Apprentice / Trainee
- Umpire
- Attorney
- Inside Adjuster
- Outside Adjuster
- Claim Specialist
- Executive / Owner
Office Staff*
Select the amount of office staff accounts to add. These accounts have access to all claims for processing purposes but are not assigned to specific claims.
- 1 Office Staff Account
- 2 Office Staff Accounts
- 3 Office Staff Accounts
- 4 Office Staff Accounts
Notes & Additional Information:
Enterprise: Account Setup
Thank you for your interest in a ClaimWizard Enterprise account. Enterprise accounts are best for businesses with 10 or more assignable accounts. Please call our Sales Team at 856-705-0201 to continue.
Your credit card will be charged automatically on a monthly basis for your subscription.