Person completing this claim form
Disclaimer: This claim will be reviewed and contact will be made as soon as possible on
the next regular businesss day following the receipt of this notice. We may not receive this claim promptly if
the report is being completed after hours or on weekends or holidays. This reporting capability is soley for
the convenience of filing a claim after hours or when it is not feasible to contact your agent during normal
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Halifax Mutual Insurance Company has been providing service, security, and stability to North Carolinans since it was founded in 1947.