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Information on Structured Settlements
I am a Plantiff Attorney
I am an Injured Person
I am a Claims Professional
I am a Structured Settlement Holder
I am a Settlement Fiduciary
 



Summit Structured Settlements
755 S.E. Frontier Suite 101
Waukee, Iowa 50263

Voice: 515.987.6888
Fax: 515.987.6999
Toll Free: 866.267.1177
info@summitsettlements.com
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I AM A CLAIMS PROFESSIONAL

Claims Professional Name:  
Phone Number:  
Fax Number:
Email:  
Insurance Company:
Claimants Name:
State of Loss/Venue:
Date of Birth: Date Of Loss:  
Defendants Insurance Company:
Description of Incident:
Amount of Total Settlement:
Has Case Been Settled:    Has Mediation Occured:
If Mediation has not accured is it scheduled:
I would like a structured settlement proposals in the amount of:
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