Auto Glass Only

Have you experienced damage to your auto that is contained only to glass and you do not wish to utilize Safelite? Did you have your windshield already repaired and need to submit the invoice? Do you need any other assistance regarding a glass only claim? If so, please complete the InterWest form below and one of our property and casualty claims professional will contact you as soon as possible but not more than 1 business day. Let our experience guide you!
InterWest Account Name*
InterWest Policy Number*
InterWest Account Address*
Street Address Address Line 2 City State ZIP Code
Claim Contact Name*
First Last
Contact Email*
Contact Phone
Incident Information
Describe the Incident and Damage*
Date of the Accident*
MM slash DD slash YYYY
Time*

: Hours

Minutes

AM/PM
Accident Location*
Street Address Address Line 2 City State ZIP Code
Insured Vehicle and Driver Information
Year*
Make*
Model*
VIN*
Insured Driver Name*
First Last
Please attach a copy of photos or any other information related to this incident.
File
Drop files here or

Max. file size: 40 MB.

Incident Information