Maxwell & Bowar contact information

Report an Insurance Claim or Accident

Report a Claim Form

No matter what time of the day or night, our online office is available for you to easily
notify us of a claim. Simply fill out the insurance claim form below, providing as much
detail as possible. One of our licensed agents will contact you to verify the claim during
business hours and submit the claim to your insurance carrier for you.

*=required information
Name*
First
Last
Address:*
Street Address:
City*
State*
Zip Code*
Daytime Phone Number:*
(xxx) xxx-xxxx
Other Phone:
(xxx) xxx-xxxx
E-Mail Address:*
Policy Number:
Date of Loss:*
MM DD YYYY
Description of Incident:*
Location of Loss:*
Additional Comments:
Human Verification Code:

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  • Parkston Office
  • p. 605-928-7956
  • 114 E. Main Street.

  • Ethan Office
  • p. 605-227-4215
  • 107 E. Main St.

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