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Submit a Claim to Shine

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Name(Required)*

First Name* Last Name*

Phone(Required)*

Email(Required)*

When did the claim happen?(Required)*

MM slash DD slash YYYY When did the claim happen?(Required)*

What Type of Claim?(Required)*

Auto

Home

Other

Please describe what happened:(Required)*

Was anyone injured?(Required)*

Yes

Who was injured?

Which vehicle was involved?(Required)*

Who was the driver?(Required)*

Is the car still drivable?(Required)*

Yes

Were the police called?(Required)*

Yes

What is the police report number?

Were any other cars involved?(Required)*

Yes

What is the other driver's information?

What address is the damage at?(Required)*

Has anyone been called to help address the damage?(Required)*

Yes

Who has been called?

Anything else we need to know?

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Bloomington, IN 47401

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At Shine Insurance, we are committed to building lasting relationships with our clients. Our goal is to offer clear, practical advice and insurance solutions that help secure your future, all while making the experience as simple as possible.

Clickable Coverage® is a registered trademark of FMG Suite, LLC, d/b/a Agency Revolution.