First Name*
Last Name*
Email Address*
Phone*
Who referred you to this position? Enter their first and last name here.
Are you currently on the Brush Claims Roster?*
-- No answer -- Yes No Not Sure
What is your Home State Adjuster License?*
States That You Hold ACTIVE License(s). Use State abbreviations.*
What is your National Producer Number?*
Do you currently hold an active Public Adjuster's license?*
-- No answer -- Yes No
Which position(s) are you interested in?*
Xactimate Field Adjusting Experience*
-- No answer -- Not Interested No Experience 1-2 Years 2-5 Years 5-10 Years 10+ Years
Xactimate Desk Adjuster Experience*
-- No answer -- Not Interested No Experience 1-2 Years 2-5 Year 5-10 Years 10+ Years
If available, please provide XactNet Address
Symbility Field Adjuster Experience*
-- No answer -- Not Interested No Experience 1-2 Years 2-5 Years 5-10 Years 10+ Years
Symbility Desk Adjuster Experience*
-- No answer -- Not Interested No Experience 1-2 Years 2-5 Years 5-10 Years 10+ Years
If available, please provide Symbility ID
Residential Field Adjuster Experience*
-- No answer -- No experience 1-100 Claims (Beginner) 101-300 (Intermediate) 301+ (Experienced)
Commercial Field Adjuster Experience*
-- No answer -- No Experience 1-25 Beginner 26-100 (Intermediate) 101+ (Experienced)
Liability Field Adjuster Experience*
-- No answer -- No Experience 1-25 (Beginner 26-100 (Intermediate) 101+ (Experienced)
What are your average claim closures per week?*
Select Peril(s) you are comfortable handling*
Select claim types you are comfortable handling*
Have you handled claims with a Public Adjuster?*
-- No answer -- Yes No
Have you handled claims with a contractor?*
-- No answer -- Yes No
How would you rate your ability to interpret policy?*
-- No answer -- 1 - Not Well 2 3 4 5 - Excellent
How would you rate your ability to decipher and execute provided guidelines?
-- No answer -- 1- Not Well 2 3 4 5 - Excellent
Are you able to complete roof inspection?*
-- No answer -- Yes No
Did you attend and graduate adjuster training program? If yes, which program and when?*
List any certification you currently hold. HAAG, ARIC, Flood, Earthquake, etc.*
Provide general coverage area for daily claims*
Are you deployable with the industry leading Brush Cat Team?*
-- No answer -- Yes No
Provide a brief summary of your experience.*
By providing your phone number, you consent to receive text messages from Brush Claims. These messages may include updates, opportunities, and important information. Message frequency may vary. Standard message and data rates may apply. Your data will not be sold or distributed to third parties. Our privacy policies regarding your personal information can be viewed here. You can opt out at any time by replying "STOP”.*
