Quick Pay Comp Claim Please use this submission form for Comp claims less than $3000. NDIRF Member Name* Date of Loss* Year of Vehicle* Make of Vehicle* Model of Vehicle* VIN of Vehicle* Dollar Amount of Claim* Loss Type* Please SelectAnimal collisionAnimal damage other than collisionFalling objectFireFlying missileFreezingGlass damage onlyHailTowingWater damageWeight of ice or snow Attach estimate/invoice* Name of person submitting form* Contact phone number*