File A Claim | Missouri Department of Transportation

The Missouri Department of Transportation (MoDOT) is committed to an efficient claims process. We will thoroughly investigate the facts surrounding this incident and expedite the processing as quickly as possible.

Note: submission of this form does not guarantee MoDOT acceptance of liability or responsibility, and is merely for fact finding and verification purposes.

The use of non-original equipment or aftermarket wheels and/or tires could possibly exclude you from eligibility for compensation from MoDOT. If compensation is paid, only components directly damaged from the incident will be considered.

County Where Accident Occurred

Claimant Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address*

Phone Number*

Date of Incident*

Time of Incident:*

Date & Time of Incident

Location of Incident*

Incident Description

Provide a brief explanation of the incident and property damaged. If vehicle damage, include make/model/year description:

Once all of the above information has been received, and verified you will be given a claim number within 10 business days. All claims will be entered into our system where they will be processed by a Claims Adjuster from our Central Office.

Some of the above fields are required and indicated by an asterisk. If your claim is successfully submitted, you will receive a popup, stating it was successful.

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