File a Claim

File a Claim
Contact Information
First Name *
Last Name *
Date of Birth

Month Day Year
Date
Mailing Address / PO Box *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Email Address
example@example.com
Primary Phone *
Secondary Phone
Person Reporting
Same as above

Yes No
Reporter's First Name *
Reporter's Last Name *
Reporter's Primary Phone *
Reporter's Secondary Phone
Incident Information
Date of Incident *

Month Day Year
Date
Time of Incident *

Hour Minutes

AM/PM Option
Is location of Incident same as Mailing Address? *

Yes No
Address of Incident *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Was a PGE vehicle involved?

Yes No
PGE Driver (if known)
PGE Vehicle ID (if known)
Was a non PGE vehicle involved?

Yes No
Make
Model
Year
Where is the damage
In detail, explain what happened.
Property Damage
Are you the owner of the damaged property? *

Yes No
Property Owner Name
Property Owner Primary Phone
Injuries
Did any injuries occur? *

Yes No
Name of Injured Party
Were there witnesses? *

Yes No
Witness Name
Witness Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Witness Phone
Insurance Info
Have you contacted your insurance company? (informative information only)

Yes No
Insurance Company
Claims Adjuster
Insurance Phone
Please provide us with copies of repair estimates, invoices, proof of purchase, photos and/or other supporting documentation. Please compile your documentation into one document smaller than 10 megs. Our investigation of your claim is not an admission of liability or an indication that PGE is responsible for your damages.
Attach a File

Cancel of
I understand that all documentation submitted in support of this claim will be reviewed by Portland General Electric. I certify that the foregoing is true and correct.

I agree
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File a Claim

Contact Information

Person Reporting

Incident Information

Property Damage

Injuries

Insurance Info