Texas Farm Bureau Insurance

Last Name of Insured

Insured last name is required

Insured last name must be between 2 and 30 characters

Insured last name contains some invalid characters

Policy Number

Policy number is required

Policy number must be between 5 and 10 characters only

Policy number must be alphanumeric characters only

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Policy Number

Policy number is required

Policy Holder Information

Policy Number:

Insured Name:

Preferred Contact Phone Number

Preferred phone number of the insured must be between 10 and 12 characters

Preferred phone number of the insured is in an invalid format

Preferred Contact Phone Number Type

Preferred phone number type is required if a preferred phone number is entered

Reporter Information

- Required Field

Name

Name of the person reporting claim is required

Name of the person reporting claim must be between 2 and 30 characters

Name of the person reporting claim contains some invalid characters

Type

Reporter type is required

Phone Number

Phone number of the person reporting claim is required

Phone number of the person reporting claim must be between 10 and 12 characters

Phone number of the person reporting claim is in an invalid format

Phone Number Type

Type of phone is required

Email Address

Email address must be between 3 and 250 characters

Email address must be in name@domain.com format

Loss/Damage Information

Date of Loss

Date of loss is required

Date of loss must be between 6 and 10 characters

Date of loss is invalid

Date of loss must be in the past

Time of Loss

Time of loss is required

Time of loss is invalid

Time of loss must be in HH:MM AM/PM format

Type of Loss

Type of loss is required

Additional Description of Loss

Description of loss must be between 10 and 1000 characters

Description of loss contains some invalid characters

Location

Location of loss is required

Location of loss must be between 3 and 40 characters

Location of loss contains some invalid characters

City

City of loss is required

City of loss must be between 2 and 25 characters

City of loss contains some invalid characters

County

State

Police Department

Police department must be between 2 and 40 characters.

Police Case Number

Police case number must be between 2 and 25 characters.

Photos

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Individual file size must be less than 10MB. Total file size must be less than 100MB

Claim Submission Confirmation

Your claim has been submitted successfully!

Claim Number:

Confirmation Number:

Please keep the above confirmation number for your records. It is not your claim number. That will be provided to you by a Texas Farm Bureau Insurance Claims Representative.

Please also note that your claim will not be viewable online until it is entered into the system by your Claims Representative.

Uploaded Files:

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Claims Adjuster

Adjuster Information Unavailable

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Adjuster Information Unavailable

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File a Claim

Policy Holder Information

Reporter Information

Loss/Damage Information

Insured Vehicle Information

Insured Driver Information

Other Party Information

Other Party Vehicle Information

Other Party Driver Information

Photos

Claim Submission Confirmation

Uploaded Files:

Claims Adjuster