Online Loss Reporting

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Online Loss Reporting 2017-01-17T10:40:47+00:00

Reporting insurance claims online is simple.

Just click on the type of loss you need to report, complete the form and submit it online.
(*Please note that this service is for ISA customers only)

Online insurance claims reporting forms are submitted to Irwin Siegel Agency, Inc. If form is submitted after business hours or on a weekend, it will be sent to the carrier for processing the next business day (Monday through Friday 8:00 a.m. – 4:30 p.m.) Before reporting a claim, please read these important state-specific fraud warnings.

Property Loss Reporting

  • Please enter your policy number.
  • Enter or select the effective date of your policy
  • Enter or select the expiration date of your policy.
  • Insured & Contact Information

    Please fill in the information below as accurately and completely as possible.
  • Please enter the name of the organization.
    Please let us know the best time to reach you.
  • Loss Details

    Please provide the following details about the loss.
  • :
    The time at which the loss occurred.
  • If not categorized above, please enter other type of loss.
  • Submission Information

    Please enter complete contact information so that we know who to contact regarding this online claim submission.
Download the Auto Accident Reporting Card or the Information Card.

Auto Loss Reporting

  • :
  • Please enter your policy number.
  • Enter the effective date of your policy.
  • Insured & Contact Information

    Please fill in the information below as accurately and completely as possible.
  • Please enter the name of the organization.
    Please let us know the best time to reach you.
  • Loss Details

    Please include the details of the Auto Loss below.
  • Insured Vehicle

  • Property Damage

  • This includes any other involved auto's year, make, model and plate #.
  • Injured Parties

  • Witnesses or Passengers

  • Submission Information

General / Professional Liability Reporting

  • Please enter your policy number.
  • :
    The time at which the loss occurred.
  • Insured & Contact Information

    Please fill in the information below as accurately and completely as possible.
    Please let us know the best time to reach you.
  • Contact Information

  • Occurrence

  • Type of Liability

  • Injury / Property Damaged

  • Please enter a value between 0 and 120.
  • Witnesses

  • Submission Information