Environmental Assignment Form

NOTE: If this is an emergency response, please contact our Environmental Department at (866)289-3824
Please complete and submit the following information regarding your Environmental claim assignment or email your assignment to New.Claims@RiverwoodTPA.com

Your assignment will be sent to our HOTLINE for immediate processing.

Required fields are marked with *

For technical assistance, please contact our IT Department at 1-877-477-2223
(Monday through Friday between 8:00AM and 5:00PM Eastern)

We are not accepting submissions with ZIP files attached at this time. You are able to select multiple files to upload with IE 10 or greater as well as Chrome, Firefox, Edge, Safari, and Opera.

Location of Adjuster Assignment

Submitted By

Report To (if different from above)

Policy Information

Loss Information

Insured Information

ZIP files will get stripped from the assignment prior to sending it to HOTLINE. You can select multiple files to upload instead as long as your browser is IE version 10 or greater, Chrome, Firefox, Safari, or Opera. To select multiple files in the File Dialog, hold the SHIFT key + mouse click to select a range of files or the CTRL key + mouse click to select individual files.