Automobile Accident Report If this accident caused serious injury or death, please do not use this online form to report the claim. Instead, call us immediately at (800) 554-2642, then select menu Option 2. Step 1 In order to handle your claim properly, your message and the information in it may need to be shared with agents or employees within the Church Mutual organization. We may also share the information with others who perform a business, professional, or insurance function for our company. By sending your message to Church Mutual you acknowledge that your message and any information in it may be reproduced or shared with agents, employees or others acting on behalf of Church Mutual without limitation. Messages sent over the Internet may not be secure. By using this form, you acknowledge that Church Mutual is not responsible for any information contained in this form which may be read or intercepted by unintended third parties. In Step 1 you are asked to indicate the number of people in your vehicle and in the other vehicle and to indicate the number of witnesses to the accident. Your responses to these questions will generate the appropriate number of reporting boxes and will simplify the reporting process for you. You might not know all of the information that is requested of you in the online form. We understand that. Simply provide the information you do know and leave other entry boxes blank.
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