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Submit a Claim

Complete the form below to request product failure analysis, manufacturer identification, evidence storage, or related services.

All inspections, where possible, include identification of the manufacturer/distributor.

Service Options

Requested Service
Do you need DPI to arrange pickup of item?
Yes
No
Shipping Assistance
After completion of report
Store item
Return item

Item will be returned upon payment of invoice.

Can we contact your insured if we need additional information?
Yes
No

Reports will be emailed to the submitting party unless otherwise directed.

Submitting Party & Claim Information

Information Pertaining to Evidence Involved in Claim

Are there receipts? Upload copy if possible
Yes
No
Upload on-site photos, cause and origin reports, receipts, or other pertinent information. Selected files will be displayed below the upload field after they are uploaded successfully.

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