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Edmonton South Branch (Windermere)
Edmonton North Branch
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Personal
Auto Insurance
Home & Property Coverage
Homeowner Insurance
Condo Insurance
Renter & Tenant Insurance
Business
Edmonton Business Insurance
Professional Services Insurance
Trades & Industrial Insurance
Retail & Service Industry Insurance
Claims
Claims
Report a Claim
24/7 Emergency Claim Contacts
About
About Us
Careers
Our Partners
Blog
Contact
Contact Us
Edmonton South Branch (Windermere)
Edmonton North Branch
Get a Quote
Claim Report - Home
This form will allow you to report a claim to our brokerage. You may save and continue later if necessary.
Your Information
Are you currently insured with our brokerage?
Yes - I am a client of the brokerage
No - I am a third party filing a claim against a client of the brokerage
Name
First
Last
Primary phone number
*
Secondary phone number
Email
Address
*
Street Address
City
Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
Your policy info
Policy number
*
Insurance carrier
*
Please Choose
Aviva Insurance Co.
Economical Insurance Co.
Intact Insurance Co.
Nordic Insurance Co.
Optimum West Insurance Co.
Peace Hills Insurance Co.
Royal and Sun Alliance Facility
Wawanesa Mutual Insurance Co.
Other - not listed
Please type in the name of your insurance carrier
*
Loss Information
When did the loss occur?
*
Date Format: YYYY dash MM dash DD
Time
:
HH
MM
AM
PM
Please describe the incident, including WHERE it occurred and WHAT exactly happened
Upload photos or documents
Drop files here or
Accepted file types: pdf, jpg, gif, png.
Please upload any files you feel are relevant (pictures, police report, etc.). Maximum 10 files, up to 2MB each.
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