Insurance Claim Form

Insurance Claim Form

We will put your claims directly through your insurance company, free of charge in order to ensure your peace of mind.Please fill out the form below and a claim representative will contact you shortly. If you have a question about the claim process, feel free to contact us at 1-800-660-6757.

Your insurance company and any of its representatives (such as agents or third-party glass claims services) are required to ask if you have a preference as to where you want the work to be done. If you want the work done by a specific company such as Jeff’s Auto Glass, your insurance company is required by law to comply with your wishes. If you have no preference, they may offer you a choice of a number of shops that can do the work.

Remember, your insurance company cannot require you to choose any certain auto glass company.

If you have any questions about this insurance claim form, please call us at 1-800-660-6757

Click Here for Printable / Fax Claim Form (pdf)


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