Allsafe Insurance Group, Inc.
7171 Coral Way, Suite 209
Miami, FL 33155
Office: 305-262-5244
Fax: 786-388-7244

Office Days: Monday - Friday
Hours: 9am - 5pm

REPORTING AN ACCIDENT/CLAIM

1. MAKE THE AREA SAFE TO PREVENT ADDITIONAL PROPERTY DAMAGE OR INJURY
    TO OTHERS.
2. CALL OUR OFFICE IF YOU NEED IMMEDIATE ASSISTANCE OR TO DISCUSS COVERAGES
    OR DEDUCTIBLES (305-262-5244)
3. DO NOT DISCUSS ACCIDENTS WITH ANYONE
4. DO NOT ADMIT FAULT
5. DO NOT GIVE YOUR POLICY INFORMATION TO ANYONE ELSE. DIRECT THEM TO CONTACT
    OUR OFFICE OR THE INSURANCE COMPANY DIRECTLY.
6. TAKE LOTS OF PICTURES
7. GET NAMES AND PHONE NUMBERS FOR ANY WITNESSES
8. KEEP RECEIPTS FOR ANY REPAIRS MADE
9. COMPLETE THIS FORM AND FAX OR EMAIL TO OUR OFFICES.

   
DATE AND TIME OF ACCIDENT:
LOCATION OF ACCIDENT:
NAME OF INSURED:
POLICY #:
EXPLAIN WHAT HAPPENED IN DETAIL:
POLICE REPORT #:
BEST PHONE NUMBER TO CONTACT YOU: