Submit a Claim - Login

To start your online Claim Form, please log in using the Claim Number and PIN you received with your Notice. If you have a Claim Number we already have existing purchase information on file for your claim. This information will be used when evaluating your claim. If you have fewer than 3 purchases reflected in our purchase data and you would like to add purchases, you will have the opportunity to do so.

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If you do not have a Claim Number and PIN, please click the button below.