You may file an initial claim report here on our web page 24 hours a day. We will call you or e-mail you a confirmation that your claim has been forwarded to your insurance company. Please BE SURE to leave a phone number where you may be reached during the next business day. We may need additional information and/or the adjuster will need to contact you.
Please go to our Tips & Info page for claims to get information on what to do and not to do immediately following your accident or property claim.
Fill in the information below to submit a claim form.
Type of Claim
Auto
Property / Home
Business Liability Claim
Your Name:
Name on Policy:
Address if different than policy:
City, State, Zip
Day Phone #
Home Phone #
E-mail Address:
Date of Accident
Auto Accident: (Please enter description of accident under additional remarks)
Location of accident:
Your Driver: (Who was Driving?)
Your Vehicle:
Is the vehicle in a drivable condition? Yes No
If not where is it being kept?
Other Driver:
Address of other driver:
Other Vehicle:
Was anyone injured?
Yes No

Did the Police come?
Yes No

If yes, which Police?
If so, did they make any citations?
Yes No
Additional remarks:
Property/ Homeowners Claim:
Please enter description. What is damaged? What happened?
Business Liability Claim
Enter description of Accident. Who was injured or what was damaged?
How do you prefer we contact you?
Please contact us if we have not confirmed the receipt of your claim by the next business day. Please see our Tips and Info on CLAIMS for what to do and what to expect in the settlement of your claim.
Thank you for using our web site!
Making Insurance Work for You!

 

 

Home | About Us | Quotes | Certificates | File a Claim

Policy Changes | Tips and Info | Contact