J.M. Strange & Company -- Insurance * Bonds

Call Us:	(713) 622-1494
Email:	Send Email

J.M. Strange & Company: Insurance - Bonds

Automobile Loss Notice

Please use the form below to notify us of any loss or damage to your automobile insured through this agency. Please note that this form is for notification purposes only and does not constitute making an actual claim. One of our representatives will contact you shortly after receiving this notification.

Disclaimer

Please note completion of any request(s) for information does not constitute the purchase of insurance. No coverage may be added, changed or bound as a result of submitting a request for information or quotation of insurance. All coverage must be confirmed by the agency in writing subject to an acceptable signed application meeting the underwriting guidelines of the Insurance Company.

	I have read and agree with the above disclaimer.
	(Box must be checked before request can be sent)

Policy Holder Information
Please be sure to supply your phone number and email address so that we may contact you after receiving this notification.
Name Insured:
Address:
Phone #:	Work Home
Email:
Best Contact Time:

Time and Location of Accident

Time & Date of Loss

Time

a.m.
p.m.

Date

Location of Accident:
(Number, Street, Intersection, etc.)

Description of Accident:

Police Notification
Were the Police Called?	Yes No
What Authority?
Were You Ticketed?	Yes No
If Yes, what for?

Your Vehicle Information
Damage to your vehicle?	Yes No
If Yes, describe:
Where can car be seen:
What car were you driving?	Yr. Make Model
License Plate #:	State
Is this your car?	Yes No
If No, were you using it with permission?	Yes No Please explain below:

OTHER Driver Information
Name:
Address:
Phone:	Work Home
Automobile:	Yr. Make Model
Driver's License #:	State
License Plate #:	State
Insurance Company:
Describe damage to other vehicle:
Where can car be seen?

Injuries, Witnesses, Etc.
If there were any Injuries, please describe:
Please list any Witnesses and/or Passengers:	(Please include Name, Address and Phone #)

Report Information
Reported by:
Title (if any):
Date:

Additional Comments

Please give any additional comments you feel appropriate for this Loss Notice.

Please click on the "Submit Form" button to send your service request.
One of our representatives will respond to your submission as soon as possible.

Refer a Friend

You made a good decision when you placed your trust in us, now we'd like you to share your experience with friends and family so that they get the insurance coverage they need, at a price they can afford.

Annual Risk Review

To get the most out of your insurance coverage for the least cost, you should submit an Annual Policy Review of your Homeowners' (Condo/Apartment) and/or Automobile policies. Click below to complete an online review. It should take less then 15 minutes!

Address:
800 Bering Dr. Ste 310
Houston, TX 77057

Email Us:
Send Email

Phone:
Fax:

(713)622-1494
(713)622-1861

Office Hours:
Monday thru Friday
9:00 a.m. - 4:00 p.m.

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Important Note: This Web site offers only a simplified description of coverages and is not a statement of contract. None of the information offered on the website is a guarantee that insurance will be provided or that the agency is obligated to procure insurance for the website visitor. Coverage may not apply in all states. Misstatements or omissions of relevant information can lead to price variation or even declination or rescission of coverage. For complete details of coverages, conditions, limits, and losses not covered, be sure to read the policy, including all endorsements, or prospectus, if applicable. Coverage CANNOT be bound, amended, or altered by leaving a message on, or relying upon, information in this Website or through E-Mail, Voicemail or Text.

Licensed in the following States: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Georgia, Idaho, Louisiana, Michigan, Mississippi, Missouri, Montana, New Mexico, New York, North Carolina, Oklahoma, Texas, Washington, Wyoming.