1-888-933-WAWA (9292)

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Create a Claim Report - Residential

If this is an emergency or ongoing loss, such as water leakage from a plumbing system, leaking roof, fire or any other cause of continuing damage, please take the necessary action to stop the damages from continuing. If this is an emergency and you need to speak to someone right away, please call your service office. Thank you.
(This web based reporting site is monitored during normal business hours).

Greater Montreal:514-342-2211
Elsewhere in Quebec:Our service offices
Toll free:1-888-933-WAWA (1-888-933-9292)

For after hours CLAIM EMERGENCY, please contact 1-855-801-0297

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    Your Information

    First Name*
    Last Name*
    Please type at least one phone number below *
    Home Phone Number
    Business Phone Number ext.
    Cell Phone Number
    Email Address
    Company Name
    File Number
    Insurance Company Name
    Insurance Company Policy #

    Loss Information

    Our Policy Number* HPC
    Date of Loss* (mm/dd/yyyy)
    Time of Loss* :
    Describe the Accident or Incident* (Limited to 25 lines)


    Other Party Information

    First Name*
    Last Name*
    Address
    City
    Country
    State
    Zip Code
    Province
    Postal Code
    Home Phone Number
    Business Phone Number ext.
    Cell Phone Number

    Our Insured Information

    Same as Your Information
    First Name*
    Last Name*
    Address
    City
    Country
    Province
    Postal Code
    State
    Zip Code
    Please type at least one phone number below*
    Home Phone Number
    Business Phone Number ext.
    Cell Phone Number

    Loss Location

    Same as insured's address
    Address
    City*
    Country
    Province*
    Postal Code
    State*
    Zip Code

    Police Report

    Was a police report obtained?


    Mortgagee

    Does the home have any mortgages?*


    How Many?

    No Mortgages


    Mortgage 1

    Name
    Address
    City
    Country
    State
    Zip Code
    Province
    Postal Code
    Home Phone Number
    Business Phone Number ext.
    Cell Phone Number

    Mortgage 2

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    Zip Code
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    Postal Code
    Home Phone Number
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    Cell Phone Number

    Mortgage 3

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    Zip Code
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    Postal Code
    Home Phone Number
    Business Phone Number ext.
    Cell Phone Number

    Mortgage 4

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    Zip Code
    Province
    Postal Code
    Home Phone Number
    Business Phone Number ext.
    Cell Phone Number

    Mortgage 5

    Name
    Address
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    Zip Code
    Province
    Postal Code
    Home Phone Number
    Business Phone Number ext.
    Cell Phone Number

    Verification Code




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