Report a Claim

Your Name

Please enter Full Name

Your EMail

EMail must be in valid format

Your Phone Number

Please enter Phone Number

Date of Loss

Time of Loss

Founders Policy Numbers on File

Founders Policy Number

Please select one:

I am insured by Founders Insurance Company

I was involved in an accident with someone insured by Founders Insurance Company

Please select either 'Insured By Founders' or 'Involved in accident with Founders insured'

Was the Insured driving a vehicle?	Yes No
Was the Insured a pedestrian/bicyclist or not in a vehicle?	Yes No
Was this a Comprehensive claim that does not involve a driver? (Examples: Fire, Theft, Vandalism, or Hail Claim)	Yes No
	Fire Theft Hail Vandalism Animal Hit or Other
Was the Claimant driving a vehicle?	Yes No
Was the Claimant a pedestrian/bicyclist or not in a vehicle?	Yes No
Does the Claimant own a fixed object (e.g., guardrail, building, fence) that was hit?	Yes No

I was in a vehicle that was in an accident with someone insured by Founders Insurance Company.	Yes No
I was a pedestrian/bicyclist involved in an accident with someone insured by Founders Insurance Company.	Yes No
I am the owner of a fixed object which was damaged by someone insured by Founders Insurance Company (e.g., guardrail, building, fence).	Yes No

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Please enter Full Name
EMail must be in valid format
Please enter EMail
Please enter Phone Number
Please select either 'Insured By Founders' or 'Involved in accident with Founders insured'