Claim Form

 

Please use the claim form below to alert us of any items that were received in a damaged condition, or any items that were not received during delivery. A Claims Counselor will contact you within two business days of receiving this completed form.

 

Before submitting your claim, please take a moment to review the following:

 

    • Claim form must be submitted in writing (electronically or via USPS) within your filing deadline.       Please contact your move counselor to determine how long you have to file your claim after delivery since various Federal and State rules may apply.

 

  • To assist in the prompt resolution of your claim, the following items are required:
      • Inventory number
      • Article description
      • Damage description
      • Age of item
      • Original cost
      • Replacement cost
      • An estimate for repairs is NOT necessary to submit your claim form. If one is needed, your Claims Counselor will make the necessary arrangements with a third party company in your area.

     

*Please do not discard damaged items or the cartons in which they were packed, as it may be necessary to inspect both.

*Please do not move damaged items as they must be inspected by the carrier at the original destination address.

*Please do not attempt to repair items before the carrier has the opportunity to inspect the damages.

CLAIM FORM BELOW

CLAIM FORM

ITEM INFORMATION

  • Step 1
  • Step 2

CONTACT INFORMATION

Details*

First

Last

Mobile Phone*

Home Phone*

Email

Move Date

Please Submit Item Details below...

Please add any additional comments here.

ITEM MODEL NUMBER

ITEM NAME

Description of Damage

Carton Damage

Weight of Item (in pounds)

Age of Item

Cost to Replace

Total Amount Claimed

Additional Comments

Attach Photos