Auto Glass Claim Form

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30 Years of Experience

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File your Auto Glass Claim here first!

Thank you for choosing Century Glass. To start your insurance claim, fill out our auto glass insurance claim form below. Our customer service representatives will call you within the hour if the form is received during business operating hours, or the next business day if received after 4:30 PM Monday – Friday. Call us directly for a faster response:

Agent Contact Information

Customer Contact Information

Vehicle Information


We are a registered member of the Auto Glass Safety Council.

We believe it’s important to educate consumers on the facts about auto glass security. Replacement auto glass that’s installed in your vehicle can come from a variety of different places and can be of a variety of different qualities. Considering that the windshield and other auto glass are actually part of your vehicle’s safety mechanisms, you should insist on OEM or OEE quality replacement auto glass. This will ensure that the windshield and other windows in your vehicle match the standards developed by the vehicle’s manufacturer and the A.G.S.C. (Auto Glass Safety Council). At Century Glass we only use urethane that sets up fast and clear with a safe drive away time of an hour. You will never get substandard adhesive with the auto glass pros at Century Glass. To prove this claim, we offer a lifetime NO-Leak warranty.