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Insurance Claim Process Form
Secure Form
If you need to make a total loss claim, fill out the form below or give our total loss team a call at 800-264-2372.
Customer Information
Type of account
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Select...
SFS
FIFS
Customer Name
*
Email Address
*
Phone Number
*
Customer Address
*
City
*
State
*
Zipcode
*
Vehicle
*
VIN
*
Account Number
*
Insurance Information
Insurance Company
*
Claim Number
*
Date of Loss
*
Adjuster Name
*
Adjuster’s Phone Number
*
Adjuster’s Email
*
Submit Claim
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