Texas Farm Bureau Insurance

Name of Person Reporting Claim

Name of person reporting claim is required.

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

Name of person reporting claim contains some invalid characters.

Phone Number of Person Reporting Claim

Phone number of person reporting claim is required.

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

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

Policy Holder Information

Policy Number

Policy number is required.

Policy number must be between 6 and 10 characters

Policy number must be alphanumeric.

Policy Number

Policy number is required.

Name

Policyholder name is required.

Policyholder name must be between 2 and 30 characters.

Policyholder name contains some invalid characters.

Address

Policyholder address is required.

Policyholder address must be between 3 and 30 characters.

Policyholder address contains some invalid characters.

City

Policyholder city is required.

Policyholder city must be between 2 and 25 characters.

Policyholder city contains some invalid characters.

State

Policyholder state is required.

Policyholder state must be 2 characters.

Policyholder state contains some invalid characters.

Zip Code

Policyholder zip code is required.

Policyholder zip code must be 5 numeric characters.

Policyholder zip code must be numeric.

Email Address

E-mail address is required.

E-mail address must be between 3 and 30 characters.

E-mail address format is invalid.

Home Phone

Home phone number is required.

Home phone number must be between 10 and 12 characters.

Home phone number is in an invalid format.

Work Phone

Work phone number must be between 10 and 12 characters.

Work phone number is in an invalid format.

Cell Phone

Cell phone number must be between 10 and 12 characters

Cell phone number is in an invalid format.

Best Phone/Time To Contact

Best contact information must be between 2 and 40 characters

Best contact information contains some invalid characters.

What type of claim is this?

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 must be between 4 and 10 characters

Time of loss contains some invalid characters.

Description of Loss

Description of loss is required.

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

State of loss must be 2 characters.

State of loss contains some invalid characters.

Police Department

Police department must be between 2 and 40 characters.

Police Case Number

Police case number must be between 2 and 25 characters.

Vehicle Information

Vehicle

Insured vehicle is required.

Vehicle Year

Vehicle year is required.

Vehicle year must be 4 characters.

Vehicle year must be numeric.

Vehicle Make

Vehicle make is required.

Vehicle make must be between 2 and 15 characters.

Vehicle make contains some invalid characters.

Vehicle Model

Vehicle model is required.

Vehicle model must be between 2 and 20 characters.

Vehicle model contains some invalid characters.

License Plate Number

Vehicle license plate number must be between 3 and 10 characters.

Vehicle license plate number contains some invalid characters.

Current Location of Vehicle

Current location of the vehicle must be between 2 and 40 characters.

Current location of the vehicle contains some invalid characters.

Insured Driver Information

Name

Driver name is required.

Name

Driver name is required.

Driver name must be between 2 and 30 characters.

Driver name contains some invalid characters.

Driver License Number

Driver license number must be between 4 and 13 characters.

Driver license number contains some invalid characters.

Address

Address must be between 3 and 30 characters.

Address contains some invalid characters.

City

City must be between 2 and 25 characters.

City contains some invalid characters.

State

State must be 2 characters.

State contains some invalid characters.

Zip Code

Zip code must be 5 characters.

Zip code must be numeric.

Home Phone

Home phone number must be between 10 and 12 characters

Home phone number is in an invalid format.

Work Phone

Work phone number must be between 10 and 12 characters

Work phone number is in an invalid format.

Cell Phone

Cell phone number must be between 10 and 12 characters

Cell phone number is in an invalid format.

Were you injured?

Yes

Injury status is required.

Describe Injuries

Injury description is required.

Injury description must be between 2 and 50 characters.

Was another party involved?

Yes

Third party involvement is required.

Other Party Information

Vehicle Year

Vehicle year must be 4 characters.

Vehicle year must be numeric.

Vehicle Make

Vehicle make must be between 2 and 15 characters.

Vehicle make contains some invalid characters.

Vehicle Model

Vehicle model must be between 2 and 20 characters.

Vehicle model contains some invalid characters.

License Plate Number

Vehicle license plate must be between 3 and 10 characters.

Vehicle license plate contains some invalid characters.

Current Location of Vehicle

Current location of vehicle must be between 3 and 40 characters.

Current location of vehicle contains some invalid characters.

Owner Name

Owner name must be between 2 and 30 characters.

Owner name contains some invalid characters.

Address

Address must be between 3 and 30 characters.

Address contains some invalid characters.

City

City must be between 2 and 25 characters.

City contains some invalid characters.

State

State must be between 2 and 25 characters.

State contains some invalid characters.

Zip Code

Other party owner zip code must be between 5 and 11 characters.

Other party owner zip code must be numeric.

Home Phone

Home phone number must be between 10 and 12 characters

Home phone number is in an invalid format.

Work Phone

Work phone number must be between 10 and 12 characters

Work phone number is in an invalid format.

Cell Phone

Cell phone number must be between 10 and 12 characters

Cell phone number is in an invalid format.

Driver of Vehicle (If Different Than Owner)

Driver name must be between 2 and 30 characters.

Driver name contains some invalid characters.

Driver License Number

Driver license number must be between 4 and 13 characters.

Driver license number contains some invalid characters.

Was anyone injured?

Yes

Describe Injuries

Injury description must be between 2 and 50 characters.

Injury description contains some invalid characters.

Witnesses

Witnesses must be between 2 and 50 characters.

Witnesses contain some invalid characters.

Please validate you are not a bot.

Claim Submission Confirmation

Claim Submission Error

Your claim has been submitted successfully!

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.

There was an error in submitting your claim.

If you need to speak with someone immediately, please call 1-800-266-5458.

File a Claim

Policy Holder Information

Loss/Damage Information

Vehicle Information

Insured Driver Information

Other Party Information

Claim Submission Confirmation

Claim Submission Error