Please take a moment to fill out this
form, a representative from C.I.S. will contact the insured. Fill out as much information as possible to help expedite
the claim. Depending on the claim, some information may not be
necessary. If you have any questions, please include them in the bottom
section of this form.
Note: Using this
form eliminates CIS from being responsible for collecting any
deductible or betterment. If you would like CIS to collect any
deductible or betterment or have a custom wheel claim, please
use the National or Chicago claim form.
Thank
you for using C.I.S.'s Internet Claim Service!
