Global Warranty Claims System

Vehicle Information

VIN Number *

Odometer Units *

Current Odometer *

Vehicle Year *

Vehicle Make *

Vehicle Model *

Repair Centre / Dealership Information

Auth ID

Repair Centre / Dealership Name *

Door Rate *

Address *

City *

Province *

Postal *

Country *

Phone Number *

Contact Name *

Contact Email Address *

Customer Information

First Name *

Last Name *

Email Address

Primary Phone Number *

Complete fields below. Enter all subtotals without tax.

Claim Details

Please include part numbers for review.

Complaint *

Cause *

Correction *

Part Type *

Total Parts *

Labour (Hours) *

Labour Cost *

Sublet

Towing

Other

Deductible

Total

Date of Occurrence *

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Please attach any supporting documents to complete your claim

Pictures of defective parts, invoice, sublet, complete estimate of repair (parts/labour), etc

Please upload all required documents from your computer.

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Sub-Total *

GST *

PST *

HST *

Total Tax *

Total Claim *

Automotive Claim: Estimate for Submission/Approval

Vehicle Information

Repair Centre / Dealership Information

Customer Information

Complete fields below. Enter all subtotals without tax.

Claim Details

Claim Details

Claims will be paid once reviewed and confirmed to be valid and within policy coverage.