Report a Claim | Report a claim online

To report a claim online, please complete the form below. A Carolina team member will contact you as soon as possible to discuss next steps. Thank you.

Important: Please call 1-800-874-8053 immediately to report any claims involving death, serious bodily injury, environmental/hazardous materials spills or perishable cargo.

In order to help us further speed up the claim handling process, you can choose to complete this document, convert it to PDF and attach it when submitting the online loss notice form: Optional Loss reporting form

Reporter information

First name

Last name

Phone number

Carolina insured information

Policy number

Carolina's Insured

Accident Description

Date

Time

Location (street/city/state)

Description/Additional Information

Injury?

Fuel spill?

Vehicle towed?

Upload any relevant documentation you wish to submit .png, .jpg, .jpeg, .bmp, .pdf file types accepted. Maximum of 50 files, each upto 25 Mb size allowed.