Submit a Claim

Please complete the following form to notify our claims department of a new claim OR contact our claims department at 1-844-531-1841. After hours, please use option#3.

"*" indicates required fields

Type of risk

Insured name

First name

Last name

Your contact information

Phone

Email*

First name

Last name

Brokerage name

Please enter the name of the Brokerage this policy was placed with

Policy number

Type of Loss

Description of loss

Please enter a description of the loss, include police file number if applicable.

Location of loss

Street Address Address Line 2 City Province Postal Code

Please enter the location of where the loss occurred

Date of loss

When did the loss occur?

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