MOTOMAXX MAKE A CLAIM
MOTOMAXX POLICY INFORMATION
Date of Loss *
Please enter date of loss.
Policy # *
MotoMaxx policy number invalid or not found.
First Name *
Please enter your first name. For business users, please fill '(org)'.
Last Name *
Your last name. For business users, please fill your business name.
Address *
City *
Phone # *
Please enter a valid phone number.
Email
Please enter a valid email address.
Prefer Contact Method Type of Claim *
Please choose type of claim.
Vehicle Info *
Please enter valid vehicle year.
Please enter the vehicle make.
Please enter the vehicle model.
MOTOMAXX POLICY INFORMATION
Insurance Company *
Primary insurer's name. It's ICBC for vehicles insured in BC.
Claim Number *
Claim number from your primary insurer. You have to report the claim to your primary insurer before reporting to Motomaxx.
Adjuster Repairer Info
OTHER INFORMATION
Brief Description of Incident *