Claims Submission

This form allows you to enter your information and submit it to our Claims Department. We will send you an email confirming receipt of your claim within one business day. Your claim number and instructions for submitting a sample will be emailed to you within two business days.

* Required
Contact Information
Claim Information
Include Images

Accepted filetypes: .gif, .jpeg, .jpg, .pdf, .png

Your message has been sent.

PLEASE NOTE:  There is a limit of a total of 5MB for uploaded files for claims.