⚠️ Disclaimer:

Important Notice Before You Proceed

Please note: Filling out this form is only the first step in notifying us of an accident. This does not complete your claim submission.

To fully submit your claim — including uploading required documents — you must click “Provide Additional Details” after submitting this form. From there, you’ll be prompted to sign up for a customer account (if you don’t already have one) or log in to continue the process.

Submitting the full claim online helps us serve you faster and more efficiently.