Our Firm   |  Our Attorneys  |  Areas of Practice |  FAQ   | Links and Resources |  Contact Us | Home Complete this form to allow us to evaluate your situation, or contact us at 617-367-8787 Your Name Mailing Address City or Town, State, Zip Code Email address Telephone Insurance Information: Name of insurer Type of insurance (disability, life, health, HMO, homeowners, auto etc.) In what state was the policy issued? The date your claim was denied Is the insurance provided through work? YESNO If the insurance is provided through work, please provide the following: Name of employer Contact information for employer Describe the nature of the problem: Please allow 24 hours for a response. Thank you for your inquiry!