FILE CLAIM

Complete the form below to report your insurance claim

Loss Information

Date of Loss *

Time of Loss *

Location of Accident *

Description of Accident *

Authority Contacted

Report Number

Violations/Citations

Policy & Insured Information

Policy Number *

First Name *

Last Name *

Email *

Residence Phone

Business Phone

Cell Phone

Street Address

City

State

ZIP Code

Upload Damage Photos & Videos (Optional)

Upload photos of the damage to speed up your claim. The more documentation we have upfront, the faster we can process your payment.

Click to upload photos or videos

Photos, videos, PDFs, Word, Excel, and more

Additional details

All sections below are optional — adding more context helps us process your claim faster.

By checking the box, and submitting this form, you consent to receive SMS text messages regarding, but not limited to send you information related to our services, including claims updates, and general customer support from Aguila Dorada. Message frequency may vary. Message and data rates may apply. You can reply STOP to opt out of further messaging or HELP for assistance, or call 888.509.2342. Please see our Privacy Policy and Terms and Conditions.