Auto Claim Report

CALL POLICE AND FILL OUT THE FOLLOWING

* Denotes a mandatory fields (n/a if not available)

1. Policy Details
RadDatePicker
RadDatePicker
Open the calendar popup.
RadDatePicker
RadDatePicker
Open the calendar popup.
2. Insured Details
3. Police Information Details
select
select
4. Driver Information
 
RadDatePicker
RadDatePicker
Open the calendar popup.
 
5. Witness Detail

IF THE WITNESS IS A MOTORIST AND YOU ARE UNABLE TO OBTAIN THEIR NAME AND ADDRESS, RECORD THEIR VEHICLE LICENSE PLATE NO.

select
All losses should be reported directly to: Joel Carey of Paisley Partners Inc.

Business No.: (905) 336-1302
Mobile No.: (905) 876-6411
Facsimile: (905) 681-1054
E-mail: jcarey@csrm.ca