File an Auto Claim

Submit an insurance claim on a church-insured vehicle

Auto Claim

Contact information

Alternate contact section (conditional logic)

Basic claim information

:
Location of accident
Address or nearest intersection
Additional location information (optional)
City
State
Zip
 

Police report section (conditional logic)

Church-insured vehicle information

Driver's mailing address
Address line 1
Address line 2 (optional)
City
State
Zip
Pathfinder outing, youth group, etc.
Address where vehicle may be seen for an estimate
Address line 1
Address line 2 (optional)
City
State
Zip

Passengers of church-insured vehicle (conditional logic)

Passenger's mailing address
Address line 1
Address line 2 (optional)
City
State
Zip

Damaged property and other vehicle information

Other vehicle information (conditional logic)

Driver's mailing address
Address line 1
Address line 2 (optional)
City
State
Zip

Witnesses

Witness information (conditional logic)

Witness's mailing address
Address line 1
Address line 2 (optional)
City
State
Zip