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)