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Your information

Policy information

Please key in your policy number information.
Ex.：730AE123456　
First 3 digit numbers：730
2 Alphabets in the middle：AE
Last 3 digit numbers：123456

Policyholder information

Vehicle registration number on your policy

Accident details

Reported to police.
Anyone injured in the accident

Damage to the Insured vehicle

Is there any damage to the Insured vehicle?
Is the Insured vehicle operable? *In case of emergency towing service, please contact at 0120-320-322.
Do you wish Chubb to take care of your vehicle’s repair? (the cost is covered if OWN damage is covered under your policy) Our network garages will pick up your vehicle and deliver to you after the repair. Also free substitute vehicle is available during the repair.

Damage to the other party

Is there any damage to the other party’s property?
What is the damage (if applicable)

Further contact details

Claim handling preferences

I give Chubb Insurance Japan full authority to handle and negotiate my case.
I want to file a claim against the other party for the loss of my vehicle.
I would like to know the amount to be paid to the other party before deciding to use my insurance coverage.
I want to pay by myself if the amount is so small as to possibly not warrant the use of my insurance coverage.
I request the claim adjuster to contact me if I have a question, comment, or otherwise something to discuss.

Final step before submission