AUTO CLAIM | Well Guard Insurance

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Automotive Claim

Insurance Information

Insurance Company and Policy Number

Name of the Insured

Contact Phone Number

Loss Details

Driver Name

Date of Loss

Time of Loss (If Known)

Please describe the loss here; including the vehicle involved, any passengers on board, and injuries sustained...

Third Party Information

Please provide the other party's name, contact information, and insurance company policy number; as well as the make, model, and licence plate number of the other vehicle invoved...

Police Information (If Applicable)

Officer Name & Badge Number

Incident Report Number

Thank you for your report.
We will get back to you soon!

Visit Our Office

Monday to Friday

from 9:00AM to 6:00PM

220 Commerce Valley Drive West, Suite 480

Thornhill, ON, L3T 0A8

Head Office

Head Office Fax

(416) 391-3211

(416) 391-4003

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