INITIAL CLAIM INFORMATION

If you have had an auto accident and would like to notify us during non 
business hours please fill in as much information as possible on the form 
below and either email the information to us or fax to our office at 
781-431-9595.

If the situation requires it, a police/operator report can be sent to you to fill out and return. You may also visit the Registry of Motor Vehicle's website at Registry of Motor Vehicles' Accident Forms.

If your car is not drivable please let us know where it is located so we can assign an insurance adjuster to take a look at it as soon as possible, usually within 2 business days. If your car is drivable a list of drive-in appraisal locations will be sent to you or the claim representative of your auto company will contact you to arrange a location. If we have any additional questions we will give you a call. Please do not hesitate to call us at 781-431-9600 should you have any questions.
 

1) Vehicle Owner Information:
Name
Address
Phone number 
When can you be reached?
Type of vehicle 
Color of Vehicle
License plate number 


2) Operator Information:
Name
Address
Phone number 
Operator License Number
Operator Date of Birth


3) Accident Information:
Date of Accident
Time of Day
Street occurring on
Town and State
Description of accident 
Describe the damage to your vehicle
Is your car drivable? 
If not, where will it be to have an appraiser view the damage, within the 
next 2 business days 
Did police come to scene? 
What police department? 
Did police take a report or issue a citation? 


4) Other Vehicle Information:
Owner Name
Owner Address
Owner Phone number 
Driver Name
Driver Address 
Driver Phone
Type of vehicle
Registration number 
Insurance Company 
What was damage to other vehicle?
Was anyone injured?
Additional Comments