Auto Claims

To help file an auto claim fill out our basic information form. This information will assist in the filing process.


This form does not replace a documented claim. After filling out this form, please contact your insurance agent to finish filing the claim.


Fields marked with a * are required

Contact Information

Policy Information

Description of Claim

Allstate Insurance Auto Owners Car Insurance Blue Cross Blue Shield of Illinois Bradford Victor-Adams Mutual Insurance Dairyland Auto The IMT Group Peru Waltham Mutual Insurance Progressive Insurance Spriska Insurance