Automobile Claim Form
…Providing claims service is the most important thing we do. (see our guiding principles)
We want to help you get things back to “normal” as quickly and fairly as possible. We would like to talk with you (336-945-3713) to help you through that process. If you are in an emergency situation, you can click on your company’s website for 24 hour contact information. You are also free to call John Wells at (336) 712-1069.
If you prefer, you are welcome to file through the following:
State / Province *
How severe was the damage? *
Bodily Injury Liability *
submissions or payments made via this website do not constitute a
binding agreement to your policy or coverages. Changes and
payments to policies are not effective or binding until you, or any
party involved, receive official notice from either your insurance agent,
or your insurance company. If you have any questions, please feel free to
Per the terms of our
we will not resell your information to any third-party.