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Tell us what happened
About you
Damage
Other Details
Submit your Claim

What type of incident was it?*

When Did It Happen?*

Select Date ×

What time did it happen?*

Select Time ×

Where did it Happen?*

Enter precise location

Please describe in detail what happened (max 1400 characters)*

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Are you a policyholder?*

Yes

Policy Number

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Policy Holder First Name

First Name

Policy Holder Last Name

Last Name

Preferred Telephone Number

Phone

Preferred Email Address

Email Address

Contact Preference

Phone

How much do you think the lost or damaged items cost?*

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If you called the police, please give us the report reference number*

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Please provide a descirption of the items lost or damaged*

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Please attach photographs, estimates or relevant documents in support of your claim

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Max file size: 128.00 MB. | Allowed file types: gif,jpeg,png,jpg,pdf,doc,docx

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You’re are almost done: Please complete the Declaration below and just click “Submit these claim details” and we’ll take it from there.

I hereby declare that to the best of my knowledge and belief that the information I have provided is correct and request you to deal on my behalf with any claims which may arise out of the accident in accordance with the terms and conditions of the Policy.

I authorize you and your attorneys-at-law on my behalf to make such admissions and settlements and give such consents as you consider necessary for the disposal of such claims and any litigation arising therefrom.

I agree

Your claim has been submitted

Thank you for submitting your claim. This is to acknowledge receipt and advise you that we will contact you before the end of the next business day. Please click on the following link to learn more about next steps: https://bciconline.com/claims-2/

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