Report a Claim Form

Start a Claim

If you are already a Rockingham Insurance customer, log in here or fill out the form below.

* Required field.

Are you a current Rockingham Insurance customer?*
- Yes
- No
I am reporting on behalf of another.*
- Yes
- No
Your Name*
Person completing this form on behalf of another.
First Last
Your Name
First Last
This field is hidden when viewing the form
Basic Information
First Name*
Name of person involved.
Last Name*
Name of person involved.
Your Policy Number
Your Insurance Company Name
Rockingham Insurance Customer's Name*
Rockingham Insurance Customer's Policy Number
Other Party's Name
First Last
Other Party's Insurance Company Name
Other Party's Policy Number
Date of Loss*
MM slash DD slash YYYY
Time of Loss
Hour*
Minute*
AM/PM*
Was this an Auto or Property incident?*
- Auto
- Property
This field is hidden when viewing the form
Auto
Please provide the details of the incident.*
Your Vehicle Information
Vehicle VIN Number
Year*
Make*
Model*
Plate Number
Rockingham Customer's Vehicle Information
Other Party's Vehicle Information
Vehicle VIN Number
Year*
Make*
Model*
Where did the incident occur?
Loss Location*
City*
State*
Zipcode
This field is hidden when viewing the form
Property
Where did the incident occur?
Loss Location*
City*
State*
Zip Code
Please enter a number from 0 to 99999.
Please provide the details of the incident.*
Was anyone injured?*
- Yes
- No
Please provide a brief description of the injuries.*
Share photos and documents that you have here. Multiple files allowed. Maximum total file size: 8 MB per file. Maximum of three files. Additional photos and information can be provided to your adjuster during the claims process.
Drop files here or

Max. file size: 8 MB, Max. files: 3.
Please provide your preferred contact details.
Email Address*
Contact Number*
Best Method of Contact*
Best Time to Contact*
Email
This field is for validation purposes and should be left unchanged.

Important Numbers

Start a non-emergency claim here with insurance coverage of your home, farm, mobile home, auto, rental property, commercial or umbrella policies.

Request roadside assistance by calling (866) 319-4824.

For a Glass Claim unrelated to an accident, please call (800) 868-6633.

Contractor insurance claims with business policies outside of VA & PA (policies with a prefix of R) are reported to: (833) 506-9238.

To file a Farm claim, please call (888) 721-6040 or submit online 24/7.

Farm Claim

File a claim for an excess and surplus lines (non-admitted) policy handled by Rockingham Specialty here.

File a Claim

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Griffin-Owens Insurance Specialists

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Griffin-Owens Insurance Specialists

Report a Claim Form

Start a Claim

Basic Information

Time of Loss

Auto

Your Vehicle Information

Rockingham Customer's Vehicle Information

Other Party's Vehicle Information

Where did the incident occur?

Property

Where did the incident occur?

Please provide your preferred contact details.

Important Numbers

Need help? Call (800) 434-7736