File a Claim

Claim Submission Disclaimer

Please note that submitting your claim through Hanby Insurance may take slightly longer than filing directly with your insurance carrier. Our agency can only process claim submissions during regular business hours: Monday through Friday, 9:00 AM to 5:00 PM.

If you submit this form outside of business hours, we’ll review and forward your claim to your carrier on the next business day.

You are always welcome to contact your insurance carrier directly to begin the claims process immediately. However, if you prefer, our team is happy to handle the filing for you to make the process as simple and stress-free as possible.

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Type of Claim

Policy Number

*If Available

Date of Loss

Time of Loss

Name of the Business

Description of the Loss

Brief Summary of what happened.

Year, Make and Model of Vehicle

Do you have photos of the damage?

Was a Police Report Filed?

If a police report was filed, what is the report number?

Was your vehicle the only one involved?

Name of the other party

First NameLast Name

Email of other Party

example@example.com

Phone Number of Other Party

Please enter a valid phone number.Format: (000) 000-0000.

Year, Make and Model of Other Vehicle Involved?

Insurance Information for other party. Policy number, carrier, etc.

Please upload any photos, police reports, or receipts (towing and glass claims).

Consent