Auto Claim – Tartan Insurance Agency, Inc.

Fields marked with * are required

Your Name*

Your Email*

Phone Number*

Policy Number*

Vehicle Year*

Vehicle Make & Model*

VIN*

Date & Time of Accident*

Number of Cars Involved*

Police Involved?*

Yes
No

Estimated % At Fault*

Estimated Damage*

Description of Accident

Is Vehicle Drivable?*

Address where vehicle is currently located

(If different from insurer's address)