Reporting a commercial auto claim should be easy. With us, it is.

Reporting your commercial auto claim starts here.

Instructions
We know filing a claim is stressful. To make it as convenient as possible, we have developed this online form. Please do your best to fill out all information in its entirety. If all details are not available at time of completion, please submit all known information in a timely manner. If you have any questions or prefer to file a claim with us directly, please call us at 888-366-1000.
Who referred you to this form today?*
Do you have a contract with East Coast Risk Management for Auto claims?*
East Coast Risk Management
Please contact East Coast Risk Management at 724-864-8745 or online via the Client Login portal at www.eastcoastriskmanagement.com to report your claim.

Business Information
Name of Insured (Business, Organization, Affiliation, etc.)*
Contact Name*
First Last
Contact Email*
Address of Business
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Business Phone Number*

Accident Information
Date of accident*
MM slash DD slash YYYY
Time of accident

: Hours

Minutes

AM/PM
Name of driver at time of accident*
First Last
Nearest Address/Location of the Accident Site
Street Address City State / Province / Region ZIP / Postal Code
In as much detail as possible, describe the events of the accident. Please remember, there is no such thing as too much information when filing a claim.*
If this was not a single auto accident, please provide as many details as possible about the other vehicle(s):
Was the auto involved able to be driven from the scene? If no, please indicate in the next section where the vehicle is currently located.*
- Yes
- No
- Unknown
Current location of vehicle involved in accident:
Did the employee sustain any injuries? If so, please describe as best as possible in next section.*
- Yes
- No
- Unknown
Please list any injuries sustained:

If photos or any additional documentation can be provided regarding the accident (police reports, photos, etc.), please upload here:
Max. file size: 300 MB.
This field is for validation purposes and should be left unchanged.
This field is for validation purposes and should be left unchanged.

The next step is easy, call 888-366-1000 Or, Contact Us