Insurance Order Form


Customer Name
*
Policy #
*
Phone Number
* --
Agency/Contact Name
Agency Phone Number
* --
Agent email
Special Instructions




How it Works:

1.) Please fill out all information.

2.) Click "Submit Form" and your order will automatically be sent to an ALLSTAR claims expert.

3.) We will contact your customer within 15 minutes and connect them, by "3-way", to the appropriate claim reporting center.

4.) We will assist them in the claim process.

5.) We will set up an appointment between 6 a.m. and 6 p.m. Monday through Friday, or between 7 a.m. and 4 p.m. on Saturdays.

6.) We will call you back and confirm reciept of the "Glass Claim Report".

It's that simple!

* - denotes a required field

last updated: 04.22.2009 2009 ALLSTARĀ Auto Glass | Hosted and Designed by Zero Access, Inc.