Report a Claim

Personal Information

First Name*

Last Name*

Address

Street Address Address Line 2 City State ZIP Code

Phone

We value your time and want to make communication as easy as possible. Opting in to our texting service provides us another way to communicate with you. Do you agree to receive text messages from Tawas Bay Insurance Agency?*

Yes, I agree to receive text messages
No, I do not wish to receive text messages

Email*

Comments

Policy Type

Date of Loss

Time of Loss

Detailed Loss Information

Please provide a detailed description of your claim:

Claim Info

Contact Numbers and Times

Please provide contact numbers and the best time to reach you:

Contact Info

I certify that information contained in this application is true and complete.

Do you agree with the terms and conditions?

Please acknowledge that you agree*

Yes, I agree

Initial*

*Required fields

Personal Information

Policy Type

Detailed Loss Information

Contact Numbers and Times

I certify that information contained in this application is true and complete.