DTRIC's experienced  claims personnel will work with you to ensure your claim is handled in a timely, accurate manner. Please complete the information below and submit it to DTRIC Insurance.

A claims representative will contact you within one business day. You can also contact DTRIC's Claims Department at 1-888-HI-DTRIC (1-888-443-8742) to file your claim.

Policyholder Information
          Field marked with an asterisk (*) are required

Policy Number*
   
First Name*
 
  		Middle Name
 Last Name*
 
Street Address*
 
City*      State*
 Zipcode*
 
Email Address
Home Phone Work Phone Cell Phone
Best Way to Contact You
Best Time to Contact You
Agent Name (if applicable)
 Agency Name (if applicable)


Description of Accident/Claim
Type of Claim* 
 
Date of Accident/Claim* Time of Accident/Claim
 
Location of Accident/Claim*
 
Description of Insured Item (Vehicle or Property) *
 
Accident/Claim Description*
 
Police Report Number
Other Party Property Damage Description (if Auto, include Year, Make and Model)
Other Party Contact Information (Names, Addresses, Phone, etc)
Witness Contact Information (Names, Addresses, Phone, etc)
Reported by (Names, Phone, etc)