Insured Name* First Last Mobile Phone*Email Who Is Your Erie Insurance Agent | Agency Insurance CarrierErie InsuranceOtherPolicy Number (If Known) What Best Describes The Cause Of The Incident* My Vehicle Was In An Accident An Animal Damaged My Vehicle Windshield | Window Damage Weather Damaged My Vehicle I Was Injured (No Damage To My Vehicle) My Vehicle, Or Its Content, Was Stolen Or Vandalized Towing Reimbursement Something Else Happened To My Vehicle What Caused The Damage To Your Vehicle? Another Moving Car | Motorcycle | Train | Bus A Parked Car Of Fixed Object An Animal A Pedestrian A Bike How Were You Injured? While Entering Or Exiting Vehicle While A Passenger In Someone Else's Vehicle As A Pedestrian While Working On Vehicle How Was Your Vehicle Damaged? Something Was Stolen From My Vehicle My Vehicle Was Stolen My Vehicle Was Vandalized My Vehicle Was Set On Fire Approximate Date Of Loss MM slash DD slash YYYY Approximate Time Of Loss : Hours Minutes AM PM AM/PM Where Did The Incident Occur? Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Are You Still At The Scene? Yes No Was Anyone Injured? Yes No I'm Not Sure Who Was Injured? (Include Names, Injuries, Contact Info, etc)What Type Of Accident Was it I was rear-ended I rear-ended someone I was in an accident with other moving cars What Type Of Accident Was it I was rear-ended I rear-ended someone I was in an accident with other moving cars Brief Summary Of IncidentInclude what vehicle is damaged and where the vehicle is locatedPolice Information (Optional)Police Department | Official's Name | Report Number Δ File A Car Insurance ClaimFile A Business Auto Insurance ClaimBusiness Auto Insurance: What is it and What Does it Cover?Nine Things to Do If You’re in a NC Auto AccidentDo I Need Business Auto Insurance?