Vehicle Damage Reporting System

Welcome to the Capitol Insurance Vehicle Damage Reporting System. Please press 'start' in order to begin.

Claim Information

Please answer the following questions about the claim below.

  *

  *

  *

Driver Side Front Picture

Please stand back 10 feet from the vehicle and take a photo from the front driver side.

Driver Side Front Picture
SAMPLE

  *

Passenger Side Front Picture

Please stand back 10 feet from the vehicle and take a photo from the front passenger side.

Passenger Side Front Picture
SAMPLE

  *

Driver Side Rear Picture

Please stand back 10 feet from the vehicle and take a photo from the rear driver side.

Driver Side Rear Picture
SAMPLE

  *

Passenger Side Rear Picture

Please stand back 10 feet from the vehicle and take a photo from the rear passenger side.

Passenger Side Rear Picture
SAMPLE

  *

Front Picture

Please stand back 10 feet from the vehicle and take a photo from the front.

Front Picture
SAMPLE

  *

Rear Picture

Please stand back 10 feet from the vehicle and take a photo from the rear.

Rear Picture
SAMPLE

  *

First Additional Picture

Please take at least three additional photos of the damage from this loss and include the first photo below.

First Additional Picture
SAMPLE

  *

Second Additional Picture

Please take at least three additional photos of the damage from this loss and include the second photo below.

Second Additional Picture
SAMPLE

  *

Third Additional Picture

Please take at least three additional photos of the damage from this loss and include the third photo below.

Third Additional Picture
SAMPLE

  *

First VIN Number Picture

Please take a clear photo of the VIN number. Find the VIN number on the driver side of the dash board.

First VIN Number Picture
SAMPLE

  *

Second VIN Number Picture

Please take another clear photo of the VIN number. This time, find the VIN number in the inside panel of the driver side door.

Second VIN Number Picture
SAMPLE

  *

License Plate Picture

Please take a clear photo of the license plate.

License Plate Picture
SAMPLE

  *

Mileage Picture

Please take a clear photo of the mileage on the dashboard.

Mileage Picture
SAMPLE

  *

Interior Picture

Please open the driver side front door and take a photo of the interior.

Interior Picture
SAMPLE

  *

Claim Information Submission In Progress

Thank you for submitting the information to Capitol Insurance. An estimate will be written and submitted to you within 2 business days. The adjuster assigned to the claim will contact you.

Please contact use with any questions at 215-956-9399 ext 2.

Submission Progress:
Current Progress:
2019 © Capitol Insurance Company