Submit a Claim Client Information Use our easy-fill claim form to submit your claim. Submit A Claim Insurance CompanyAdjuster NameAdjuster Email Address Street Address City ZIP Code Phone #ExtensionFax #Claim Number(Required)DeductiblePolicy NumberInsured / Clamaint InformationName First Last Phone #Address Street Address Address Line 2 City ZIP Code Loss InformationSelect a Loss TypePropertyAutoOtherLoss Unit typeAutomobileHeavy EquipmentInland Marine / BoatMotorcycleRecreational VehicleMotorhome / CamperSnowmobileLoss Unit MakeLoss Unit ModelLoss Unit VIN (if applicable)Date of Loss MM slash DD slash YYYY Type of LossCollisionComprehensiveAnimalCargoCollapseFireFreezeHailIce/snowLiabilityLightningSmokeVandalism/theftVehicleFlood / WaterWindOtherLoss Unit LocationWhere is the loss unit currently located – ie with owner, at a shop, tow yard, etcAddress Street Address Address Line 2 City ZIP Code Loss DescriptionUpload any files relevant to your claim here (optional):Files Drop files here or Select files Max. file size: 100 MB.