Indemnity - Claim Process

File a GAP Claim

GAP Claim Assignment Info Sheet (Please fill out completely to avoid delays)
Date of Loss	Has your vehicle been declared a total loss? Yes No	Agreement Number
Have you filed a claim with your insurance company? Yes No		If no, then name of our customer
Your Name		Home Phone
Address		Business Phone
City	State	Zip
Vehicle Information
Year	Make	Model
Last six numbers of your VIN (vehicle identification number)
Your Finance Company/Lendor Information
Company		Voice Phone
Address		Account Number
City	State	Zip