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File an Auto Claim

 

Filling out this form does not replace a documented claim. It is used to help expediate your claim. Please contact your insurance agent to file a formal claim.

 

*Required fields

 

Contact Information

Your Name:* (As listed on your policy)

Phone Number:*

Email Address:

 

Description of Loss

Date of accident: (MM/DD/YEAR)*

Time:*

AM / PM:*

Location:*

Description of Accident:*

Was the police notified*

Were you ticketed*

If you received a ticket, what for:*

Driver's Name:*

Any additional information:

 

 

 

 

 

Our mission at Campbell Insurance is to help guide and educate our clients about insurance to help fit their individual needs. We are always striving for a higher standard of customer service.

Treating our clients problems as our own, we are committed to a high standard of customer service.

“It’s my job to find our
customers the right coverage.
What’s the best for them.”

Alexis Chambers
Owner
alexis@campbellsinsurance.com

Campbell Insurance Services, Inc. | 416 West Main St. | McNabb, Illinois 61335 | Phone: 815-882-2122