Claim Submission - If any injuries, please do NOT use - either call us immediately (952)927-8481, or scroll to the bottom of this page to find the phone number for your insurance company.
If you do not get a response within 24 hours (not including weekends, or holidays) of submission, please call us (952)927-8481
| Name: | |
| Phone (include cell &/or daytime #): | |
| Date & Time of Loss: | |
| Location: | |
| Driver (if not a member of your household, please provide contact information): | |
| Description: | |
| Vehicle Involved: | |