Company

Auto

Were you or one of your employees involved in an auto accident? Complete the below form to the best of your ability and an InterWest property and casualty claims professional will contact you as soon as possible but not more than one business day. If this is a claim involving major injuries or death, see the Emergency Claim Reporting Instructions under the Submit A Claim page. We ask you complete the form with the available information, however, if you do not have the information or it doesn’t apply simply leave it blank. Let our experience guide you!

Incident Information

Yes
No

Insured Vehicle and Driver Information

Yes
No

Other Vehicle and Driver Information

Yes
No

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