The following information is required in order to initiate the claims process, be it online or via the telephone. Please ensure that this information is accurate before proceeding. Once this form has been completed and submitted, you can expect a call from an IAS representative within 1-2 business days.
 
  * Required items are marked with a red star.
Contract Number: *
VIN Number: *
Name as printed on warranty: *
Current Mailing Address: *
   
City: *
State: *
Zip: *
Home Phone: *
Daytime Phone: *
Email Address:  
Dealer purchased from: *
Vehicle Year: *
Vehicle Make: *
Vehicle Model: *
Date of Purchase: *
Current Mileage: *
Date of Loss: *
(Required for GAP, Tire, and Theft claim types.)
Type of Claim: * GAP
Tire
Theft
Paint / Fabric / Wear
Red Alert / Daytime Running Lights
Windshield Repair
Paintless Dent Repair