Contact Us - Summit Structured SettlementsSummit Structured Settlements

Request a Proposal

You may request a no-obligation proposal by completing the short form below. With this information, it is quick and easy to receive an annuity proposal from us.

Type of Claim(Required)

Consultant You Prefer(Required)

YOUR CONTACT INFORMATION

First Name(Required)

Last Name(Required)

Phone(Required)

Email(Required)

INJURED PARTY INFORMATION

First Name(Required)

Last Name(Required)

Date of Birth

Insurance Carrier Responsible for Payment

Insurance Claim Number

INSURANCE INFORMATION

Date of Loss

Cash Settlement Amount

Amount to Structure

State of Jurisdiction(Required)

Additional Information/Special Needs

Summit Structured Settlements

7155 Lake Dr, Ste 110
West Des Moines, IA 50266

866.267.1177 866-572-4754 (Fax) 866.267.1177 (Toll-Free)

info@summitsettlements.com