Intact Insurance Accident & Health

Injury Protection Claim Reporting

Getting Started

Fill out each section thoroughly and to the best of your ability.

Forms must be completed in a single session. Information will not be saved.

Requirements

Estimated Completion Time: 20 minutes

You will need the following information:

Driver information

Vehicle information

Accident information

Injury Information

Healthcare Providers

Prior Medical History

Prior Physicians

Income Benefits

Medical Insurance Coverage

Education

Employment

Once the form is completed, signed and submitted, you will receive an email of acknowledgement.

If your injuries require immediate attention, go directly to the nearest hospital for medical treatment or call 911.