Lead capture pattern, built
An intake form that splits a filed claim from one that isn't yet.
A restoration job, a storm-damaged roof, and a cracked windshield often start with an insurance question before a repair one. This pattern asks that up front and routes a claim already in motion straight to whoever handles carriers, instead of the general estimate line.
- Built into a one-time site package, from $1,500
- $0 setup, no claims-software fee
- 30-day guarantee: no results, no bill
How the form works
A claim number, a carrier name, and a route that skips the wrong queue.
The questions it asks
The visitor first says whether this is an insurance claim or a private-pay job, which branches the rest of the form. A claim answer asks for the carrier name, a claim number if one exists, and the date of loss, alongside a photo upload of the damage.
The logic behind it
An existing claim number routes straight to a claims coordinator who works directly with adjusters. No claim filed yet sends the visitor a plain description of how to start one and books an inspection first, since pushing someone to file before an assessment is the wrong order of operations.
What the visitor sees
A confirmation repeats the claim number and carrier name back exactly as entered, so a typo surfaces right away, and states clearly that a full estimate still needs an inspection, not a promised payout figure.
Where the lead lands
The request lands in the CRM tagged with carrier name and claim number as searchable fields, so the office can pull every open file for a given carrier at a glance, plus an email to the claims coordinator's own inbox, separate from the general estimate queue.
Why claim intake needs its own branch
The acceptance test
Before this goes live, we submit a real test claim with a carrier name and claim number and confirm it lands correctly tagged in the CRM and reaches the claims coordinator's inbox, not the general estimate folder.
The follow-up sequence
A check-in fires a set number of days after the inspection if the claim hasn't moved forward, since adjuster response times vary and a file left untouched too long often walks to a competitor instead.
Carrier work runs on its own real rules
Property insurers frequently require an estimate scoped to their own line-item pricing software before approving costs, and auto glass replacement is a zero-deductible item on many policies specifically to encourage prompt repair, both facts a claims-focused shop already works around daily.
What this does not do
This form does not file a claim with the carrier on the visitor's behalf, does not estimate or guarantee what a carrier will approve, and is not a substitute for licensed public adjusting advice.
How we build this into your site
01
We learn your real claims workflow
We work from how your claims coordinator actually handles a filed claim versus a fresh loss, and which carriers you already have a direct relationship with, so the routing matches real practice.
02
We build and test the branching form
The claim and non-claim paths ship as real, tested branches, so a visitor never ends up in the wrong queue because of a single wrong click.
03
We connect the CRM tags and the coordinator inbox
We wire carrier and claim number as searchable CRM fields and route claim requests to the coordinator's own inbox, separate from routine private-pay estimates.
Insurance claim intake form, answered
No. It only captures the details cleanly on our end. Filing the claim itself, or working it with the adjuster, stays with your claims coordinator or the homeowner.
The form still accepts the request, gives a plain explanation of how to start a claim, and books an inspection first, since an assessment should come before anyone is pushed to file.
No. Only the carrier's adjuster decides that. This pattern helps get the right information to your team fast, it does not predict a payout.
It can. A carrier you already have a direct relationship with can be flagged so the coordinator recognizes it immediately, versus one your team is dealing with for the first time.
Restoration companies, roofing contractors doing storm-damage claims, auto glass shops, and collision repair shops, or any business where a real share of jobs start with an insurance question.
Want this built for your team?
Tell us how your claims coordinator handles a filed claim today, and we will scope an insurance claim intake form around it as part of a one-time website build. A free proposal lands within one business day.