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Regency Insurance Group, Inc.
Claim Report

*NAME:

POLICY NUMBER:

*DATE OF CLAIM:

DESCRIPTION:
(Include vehicle id numbers and names of any injured people, if known)

*PHONE NUMBER TO CONTACT:

*Required field

 
   

 

 


We are a Best Practices Agency
(We are a Best Practices Agency. Click here to learn more)


1690 Watertower Place, East Lansing, MI 48823
   
PH: 800.686.6640    517-664-2770     FAX: 517-664-2787