Please complete the form below. If any of the required information (indicated by an * ) is not available, please type UNKNOWN except for required telephone numbers and zipcode. Click on the Report Claim button to start processing your claim. If you have any question(s), call  us at  1-877-STAR-210. Company Star Casualty Insurance Company Reporting Person  NameTelephone#Best time to call*Email*Report by Insured Claimant Attorney * Insured Information Home phone# Policy#Work phone#Cell phone# NameAddressCityState FL Zip Code Email**** * At least one phone# required* Loss Information Loss DatePolice Report Case No.Authority contactedViolations/CitationsAccident locationLoss Time: AM/PM***** Accident Description * Driver Information Driver's NameHome Phone#Work Phone#AddressRelation to insuredD.O.BDriver License#** Insured Vehicle VIN#YearMakeModelTag#Vehicle LocationDescribe DamageTow CompanyPhone#*****Color Y N Is vehicle drivable?Was vehicle towed? Y N Claimant #1 Information Note: This section refers to the information of the person you had the accident with. Owner AddressHome phoneWork phoneDriver NameAddressBest time to callHome phoneWork phone***Property Description*Vehicle Location*Describe damage*Ins. companyVIN#YearModelPolicy#Tag#MakeProperty Damage Y N Is vehicle drivable? Color Claimant #2 Information Note: This section refers to the information of the person you had the accident with. Owner AddressHome phoneWork phoneDriver NameAddressBest time to callHome phoneWork phone***Property Description*Vehicle Location*Describe damage*Ins. companyVIN#YearModelPolicy#Tag#MakeProperty Damage Y N Is vehicle drivable? Color Claimant #3 Information Note: This section refers to the information of the person you had the accident with. Owner AddressHome phoneWork phoneDriver NameAddressBest time to callHome phoneWork phone***Property Description*Vehicle Location*Describe damage*Ins. companyVIN#YearModelPolicy#Tag#MakeProperty Damage Y N Is vehicle drivable? Color Injured Phone#Cell#AgeVehicle Name/Address Insured Vehicle Pedestriam Claimant1 Claimant2 Claimant3 Insured Vehicle Pedestriam Claimant1 Claimant2 Claimant3 Insured Vehicle Pedestriam Claimant1 Claimant2 Claimant3 Extent of injury Insured Vehicle Pedestriam Claimant1 Claimant2 Claimant3 Insured Vehicle Pedestriam Claimant1 Claimant2 Claimant3 Name/AddressAgeCell# Phone# VehicleExtent of injury Name/AddressVehicleCell# Phone#Age Extent of injury Name/AddressVehicleAgeExtent of injuryCell# Phone# Name/AddressVehicleAgeExtent of injury Phone#Cell# Witness or Passenger Phone#Cell Phone#VehicleName and Address Ins Oth Ins Oth Other(specify) Witness Passenger Type Witness Passenger Remarks To proceed with your claim, the following error(s) need to be corrected. Reporting person's name is required Reporting person's telephone is required Best Time to Call is required Insured name is required Insured address is required Insured city is required Insured zipcode is required At least one Insured phone# is required Policy Number is required Case # is required Loss Date is required Authority contact is required Accident Location is required Loss Time is required Accident Description is required Vehicle's Driver name is required Vehicle's driver address is required Vehicle's VIN# is required Vehicle's Make is required Vehicle's Year is required Vehicle's Model is required Vehicle's location is required Claimant 1 Owner is required Claimant 1 Address is required Claimant 1 Driver Name is required Claimant 1 Property description is required Claimant 1 Vehicle Location is required Claimant 1 Damage description is required Claimant 2 Owner is required Claimant 2 Address is required Claimant 2 Driver Name is required Claimant 2 Property description is required Claimant 2 Vehicle Location is required Claimant 2 Damage description is required Claimant 3 Owner is required Claimant 3 Address is required Claimant 3 Driver Name is required Claimant 3 Property description is required Claimant 3 Vehicle Location is required Claimant 3 Damage description is required