Online Claims Form

Insurance claims can be submitted directly to the RMA through our form below. If you have any questions, please email claims@RMAInsurance.com.

Tell us what happened. *

Please provide any additional information or description of the incident. *

What is the date and time of the incident? *

Where there any witnesses? *

If you’re able to, please provide the GPS latitude and longitude of the incident.

If you have photos of the incident or an incident report, please attach.

Drag & Drop Files, Choose Files to Upload You can upload up to 10 files.

What is your name? *

First

Last

What is the name of your organization? *

What is the best phone number to reach you at? *

What is your email address? *