Submit a Claim

If you have a policy with us and a claim to submit, please use the Notice of Loss form provided here.

You can either:
a) download the Notice of Loss form, fill it in and mail or fax it to us,
or
b)  fill in the Notice of Loss form below and submit it electronically.

Name of Applicant: * required field
Address: * required field
City: * required field
Province: * required field
Postal Code: * required field
Telephone: * required field
Other Phone:
Email: * required fieldEmail Addresses do not match.
Confirm Email: * required fieldEmail Addresses do not match.

A NOTICE OF LOSS must be submitted within 3 days after damage to crop. Advice to local agent is not sufficient. Send a notice direct to the office issuing the policy whose address is printed above. Any letter form of reporting a hail loss is acceptable.

This form supplied for your convenience.

Today's date

Please take notice that the following growing crops insured under the above policy were damaged by hail on at about o'clock .

Policy Item No.No. of AcresKind of GrainQtrSectionTwp.RangeMer.Type of DamageStage of Growth when Hailed

The town nearest the loss

I reside on the Quarter of Sec Twp Rge , Miles of said section.

Note- I am aware that, according to the policy under which I am making claim, that if, for any reason, the insurer is not liable for loss, then I am liable for the expense incurred by the insurer for investigating said claim, and on demand, I promise to pay the insurer all such expense.

THE INFORMATION BELOW IS REQUIRED UNDER THE PROVINCIAL INSURANCE ACT.

Company Other Hail Insurance on Same Crops Amount Per Acre