Auto Physical Damage / Liability Claim

Please review the important information (state specific) below, click “I Accept” at the bottom of this page and submit the subsequent form. By clicking on “I Accept” and filling out the appropriate form, you are stating that you understand your state specific laws and are willing to proceed.

How to Submit Your Claim

Icon: Step one

Review and Accept State Laws

Please read the state laws below and select the “Accept” button to proceed to the claim reporting form.

Icon: Step two

Complete Form

Please ensure required fields are filled.

Icon: step three

Submit Claim

Select “Submit” at the bottom and our team will contact you with next steps.

State notices and disclaimers

File Your Auto Claim

Information on Insured Vehicle

Does the insured vehicle have physical damage coverage?
Was the insured vehicle damaged?
Is the insured vehicle driveable?
Was anyone injured?
Were there any witnesses?
Was a police report filed?

Information on Other Vehicle Involved

Was another vehicle involved in the accident?
Is the other vehicle drivable?

Maximum 4 files.
1 GB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

Please confirm that you have entered all fields marked with an * and click on the Submit button again.

If you are not able to submit our form, please send the information and any attachments directly to [email protected].

 

We are working to resolve the issue.