Roadside Refund Claim Form - CAA Manitoba

While CAA Manitoba strives to be available to always service its Members, there are situations when third party services are required or recommended. In these situations, Members must complete the following claim form for reimbursement consideration.

Please note, before you submit a claim, review the following criteria, and ensure you have all information and documentation requested to expedite the claim process. Any mandatory missing information may result in a delay and/or denial of your claim. 

To be eligible for reimbursement consideration, Members must:

  • Contact and be advised by CAA Manitoba to proceed with third party service.
  • Have an active membership at the time of third party service (reimbursement will not be considered if a membership was purchased after a road service event whereby 3rd party services were utilized).
  • Have at least one service call available for use at the date and time of the road service event. 
  • Submit their claim within 60 days of service.
  • Provide all mandatory information and supporting documentation requested on the claim form (including itemized receipts – non-itemized receipts will not be considered). 
  • Claims and accompanying documentation must bear the Member’s name.

The following circumstances are excluded from reimbursement:

  • Service provided for non-members.
  • Police-ordered service for a legal infraction.
  • Accidents with a Manitoba Public Insurance (M.P.I.) claim.

For complete details on claim reimbursement eligibility, please review our Membership Terms and Conditions.

Should you experience issues with submitting any supporting documents, or with the online claim form itself, you can download a copy of the form here and email it along with your supporting documents to: mbersclaims@caamanitoba.com.

There are error(s) found in the information you submitted.

    Member Details

    All fields are required unless marked optional.

    Format: 16-digit number
    Format: L#L #L#
    Format: xxx-xxx-xxxx
    Format: name@url.com

    Vehicle Details


    Service Provider/service details.

    (Optional) Format: xxx-xxx-xxxx
    Format: MM/DD/YYYY
    Format: HH:MM
    Format: Street address, City, Province/ State and Country name
    Format: xxx-xxx-xxxx
    Format: xxx-xxx-xxxx
    (Optional)

    Whether an accident tow or not, please complete the following:
    (Optional)
    Emergency Road Service Terms & Conditions

    Supporting Documents

    Please upload any applicable documents (PDF, JPG, JPEG and PNG):

    1. Receipts
    2. Membership Card
    3. Letter from your insurer confirming they will not be covering the claim
    4. Corresponding incident report / provide report number
    5. Police Report
    6. Insurance Slip
    7. Applicable documentation from a government-authorized tow provider
    Note: If your total files size exceeds 20 MB your reimbursement request will not be processed. The max number of files allowed is 10.
    Please upload any applicable documents in any of the following format: PDF, JPG, JPEG and PNG
    reciept.jpg
    2 mb
    reciept.jpg
    2 mb
    reciept.jpg
    2 mb
    reciept.jpg
    2 mb
    reciept.jpg
    2 mb
    reciept.jpg
    2 mb
    reciept.jpg
    2 mb
    reciept.jpg
    2 mb
    reciept.jpg
    2 mb
    reciept.jpg
    2 mb

    (Optional)