File a Claim - Wisconsin Mutual Insurance Company

Report All Claims to Your Agent

To ensure the fastest and most accurate support, please report all claims directly to your local insurance agent. Your agent will guide you through the process, gather the necessary details, and promptly initiate your claim on your behalf.

If you have already contacted your agent or our Emergency Claims number, you should not complete this form.

Claims Form

A person who files a claim with intent to defraud or helps commit a fraud against an insurer is guilty of a crime.
Claimant / Contact Information
Name:*
Phone Number*
Email:*
Address:*
City:*
State:*
Zip:*
Loss Information
Date of Loss:*
Time of Loss:*

: Hour

Minute

AM/PM
Facts of Loss:*
Damages*
Supporting Documents
Max. file size: 5 MB.
Wisconsin Mutual Policy Info
Policy Number:*
If you do not know your Policy Number you can find it on your account page.
Related Claim Information
If this loss has also been reported as a claim with another insurer, please provide the related claim information below. This section may be completed by the claimant, insured, or an insurer submitting the claim.
Other Insurance Company
Related Claim Number
Related Policy Number
Adjuster Name
Adjuster Phone Number
Adjuster Email Address
Applicable to Auto Only
Driver Name & Relationship:
Vehicle Make, Model & Year:
Injuries? If yes, please describe:

Report All Claims to Your Agent

Claims Form

Claimant / Contact Information

Loss Information

Wisconsin Mutual Policy Info

Related Claim Information

Applicable to Auto Only

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