Third Party Claim Reporting Form
Third Party Incident Notice
* - Denotes mandatory field
Intersection/Location of Incident* :
Description of Incident :
Your Claim Number from Another Insurer (e.g. State Farm 123456E) and Additional Details :
Our receipt of this information does not constitute and should not be construed as an admission of liability or a commitment to coverage or payment under an insurance policy. The information transmitted to James River Insurance Company may be shared with a third party for driver validation. Please allow for 36 hours to process your claims notice before resubmitting.