Submitting Claim Form

Online Claim Submission

Please fill out the Form below to the best of your ability. The more information you can provide the quicker CARco can begin to process your claim.

By submitting this form you are requesting that CARco open a claim under your waiver or addendum. The purpose of the form is to inform CARco of your loss and your intent to pursue coverage. Claims will be entered in the order they are received. CARco's business hours are Monday through Friday, 9am - 5pm EST all Claims submitted outside of these hours will be received on the next business day.

For all other claims, please call CARco at 877-902-8790 during business hours.

Claim Type

Contract No

Dealership

Purchase Date

Vehicle Year

Vehicle Make

Vehicle Model

Vin

Beginning Mileage

Ending Mileage

Preferred Language

Customer Name

Customer Street

Customer City

Customer State

Customer Zip Code

Phone Number

Email Address

Check this box if you do not have an email address. Email addresses will only be used by CARco to communicate with you during the claims process. Please note that the absence of email may affect your claims processing time.

Lender Name

Lender Street

Lender City

Lender State

Lender Zip Code

Account Number

Loan Term

Interest Rate

Claim Payor

Claim Number

Insurance Company

Date of Loss

Adjuster

Cause of Loss

Phone Number

Online Claim Submission

Contract Information

Vehicle Information

Customer Information

Lender Information

Insurance Information