If you have ANY information regarding a potential claim, please go ahead and report whatever information you have (even if it is incomplete). The sooner claims are reported, the quicker ACG can start the investigation.
Description of Loss
Description of Auto(s)/Equipment Involved
Description of Reported Injuries
Person Reporting Loss
Please upload any additional information you have (i.e. police report, vehicle estimates, photos, contracts, etc.)
If you have any issues with submitting this claim form, please contact us at 1-800-337-8131 or e-mail us at email@example.com.