Submit Claim

Claim Information Form

Enter your policy number to identify the contract type, use screenshot autofill for remaining fields, and submit. Supporting documents are optional — AI underwriting will request anything else needed.

Policy Lookup

Enter the contract/policy number (e.g. FWVL041518). The prefix identifies the contract type — no policy document upload needed.

Policy / Contract Number

Contract Type

Portal Screenshot Autofill

Upload one or more screenshots from your claims portal and AI will extract visible fields to autofill the form. PNG, JPEG, or WebP — max 5 MB each, up to 10 images.

Policy Information

Coverage Details

Policy Effective Date

Policy Expiration Date

Vehicle Information

VIN

Make

Model

Year

Odometer Reading

Claimant Information

Name

Contact Information

Relationship to Vehicle

Incident Details

Date of Loss

Description of the Incident

Location of Incident

Repair Information

Repair Estimate ($)

Detailed Repair Description

Repair Shop Information

Supporting Documentation (optional)

Attach any supporting files you have — none are required at submission. Each file must be 10 MB or smaller. Contract type is identified from the policy number. If more documentation is needed, AI underwriting will request it and check against Freedom Warranty guidelines.

Proof of Ownership

Maintenance Records

Prior Claims History

Inspection Reports

Service History