Submit an Auto Claim

Use this form to make a motor vehicle claim with Four Points Insurance.

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This field is for validation purposes and should be left unchanged.

Person Reporting the Claim(Required)

First Last

Policy Number

ICBC Claim Number

Report your claim to ICBC before reporting to Four Points Insurance.

Driver’s License Number

Please provide the number of the operator at the time of the accident.

Insured Name

Leave blank if name is the same as the person reporting.

First Last

Phone(Required)

Email(Required)

Insured Address(Required)

Street Address City Province Postal Code

Your Insurance Broker

Your Insurance Broker's Phone

Broker Address

Street Address City Province Postal Code

Vehicle Status(Required)

Year

Vehicle Make

Vehicle License Plate Number

Please provide the number of the insured vehicle involved in the accident.

Vehicle Model

Date of Incident(Required)

Type of Claim(Required)

Please select the closest match to your claim.

Details(Required)

Please provide an explanation of what happened in one to two sentences.

Attachments

If applicable, please attach any receipts, invoices, or photos. Up to five files can be attached.

Drop files here or

Accepted file types: jpg, jpeg, png, pdf, Max. file size: 10 MB, Max. files: 5.