Report A Claim

Claims Notice of Loss

If you are human, leave this field blank.

Please complete all of the forms below, where applicable. This information will help us access the correct policy. Report a claim online here if you are one of the following:

Policy Holder
Were in an accident with a Hallmark policyholder
Are an insurance agent/representative
Are an attorney or healthcare provider

Does this claim involve a fatality or environment spill? *

Yes

Name *

Primary Phone *

Secondary/Alternative Phone

Email *

Policy # *

Description of the Loss

Date of Occurrence *

Time of Occurrence

Location of Occurrence

List Insured Vehicle/Property involved

Describe what happened & damage

Provide Injury Descriptions and Injured Party Name(s)

Number of Occupants Involved (if applicable)

Complete if the Occurrence involved another Vehicle

Other Vehicle Owner Name

Phone

Describe Vehicle Damage, Year, Make & Model

Attach photos of the damage or corresponding forms

Drop a file here or click to upload Choose File

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Two Lincoln Centre
5420 Lyndon B. Johnson Freeway
Suite 1100
Dallas, TX 75240-2345
817-348-1600

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Report A Claim

Description of the Loss

Complete if the Occurrence involved another Vehicle

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