To perfect our Customer Claims experience, we have provided you, the Agent, with the below form to help expedite your claims. Just fill out your claim information and click "Submit" and the form will be emailed directly to us.

Immediately upon receipt of your form, your customer will be contacted and assisted in every aspect of the claims process. This assistance includes on-site estimating, pick up & delivery, rental car needs, and anything else that will help make this process easy for your customer and, therefore, happy with you and your agency. The quick response and efficient attention that we give your customer will also help decrease the need for repeat calls from your customer to check on their claim.

Upon completion of the repair, we will email you a notice of completion which provides you with the opportunity for a timely follow-up call to your customer to insure satisfaction and possibly assist them with other services that you may offer. Together, we can make their claim a positive experience for everyone involved.

Click here for the Collision Repair Fax Sheet (PDF) or fill out the form below to submit electronically.
Online Collision Repair Form
Policy Holder Name
Policy Holder Number
Deductible Amount
Vin #
Year, Make & Model of Vehicle
Phone - First Preference
Phone - Second Preference
Agency/Contact Name
Agency Phone
Special Requirements
Please contact us if you have questions filling out this form.
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