File a Vehicle Damage
Claim

This form is for vehicle damage only. Please complete all requested information to ensure the immediate investigation and processing of your potential claim. All claims must be completed and submitted to the Indiana Toll Road within 14 days of the incident.

 

Personal Information

Name(Required)

Vehicle Information

Owner's Name(Required)
Address

Incident Information

MM slash DD slash YYYY
Time
:
Please include location, direction, and mile post.
Did this incident involve road debris?
Was anyone in your vehicle injured?
Was anyone a witness to the incident?

Insurance Information

Agent Name
Address
Is your insurance company currently processing a claim for this incident?

Upload Documents

Upload the following information to expedite your processing time:
  • Please upload and attach insurance information (company name, policy number, agent's name and address, what insurance you have, etc.)
  • Two competitive estimates from licensed repair facilities
  • Photographs reflecting damage to your property
  • Did you file a police report? (If yes, please attach a copy)
  • Proof of Indiana Toll Road travel (receipt or copy of transponder statement)
Drop files here or
Max. file size: 1 GB.

    Password recovery

    Enter your email address to which a password reset link will be sent.
    If you have forgot your username, email procurement@indianatollroad.org for assistance. Please do not attempt to create a new account, as that will delay your access.