Auto Claim

If this is a claim emergency, please call 1-844-929-2637 . We're available 24/7.

Your Wawanesa Insurance policy number is required to complete this claim form.

Asterisks indicates a required field

Reporter Information

Reporters Contact Information: Please type at least one phone number below

Loss Information

Wawanesa Insured Information

Driver Information

Is the driver of the insured vehicle same as above?

Driver of the Insured Vehicle

Wawanesa Insured Vehicle

Police Report

Was a police report or joint report obtained?

Other Parties

Are there additional other parties not reported above?
Solo Vehicle Loss - No Other Party Involved

Other Party 1

Other Party 1 Vehicle Information

Other Party 2

Other Party 2 Vehicle Information

Other Party 3

Other Party 3 Vehicle Information

Other Party 4

Other Party 4 Vehicle Information

Other Party 5

Other Party 5 Vehicle Information

Passengers / Witnesses

Were there any passengers in any of the involved vehicles?
No passengers in any involved vehicles

Passenger 1 Information

Passenger 2 Information

Passenger 3 Information

Passenger 4 Information

Passenger 5 Information

Were there any witnesses?
No Witness

Witness 1 Information

Witness 2 Information

Witness 3 Information

Witness 4 Information

Witness 5 Information

Version: -2024-01-25