Submit a GAP claim

Upload a complete claim package so the claims team can review eligibility, documents, benefit calculation, decision, and payment status.

Optional Document-Retrieval and Claim Concierge Service — $24.00

For purposes of this election, “GAP Provider” means the provider, obligor, insurer, or claim administrator identified in the applicable GAP Agreement or claim form.

You may submit your GAP claim and all required supporting documents yourself by email, telephone, U.S. mail, or another available no-cost submission method. There is no fee to file a claim, have a claim adjudicated, or receive an approved GAP benefit.

As an optional convenience, you may authorize the GAP Provider to perform certain document-collection and administrative tasks that you could otherwise complete yourself. The fee for this optional service is $24.00.

Read the full terms: services included, document-retrieval authorization, and service limitations

Services included

If selected, the service may include:

Contacting your lender, lessor, or account servicer to request available payoff statements, finance agreements, payment histories, account information, product-cancellation information, and other documents you would otherwise be responsible for providing;
Contacting your primary motor-vehicle insurer, insurance agent, or claim administrator to request available proof-of-loss documents, settlement statements, valuation reports, deductible information, payment confirmations, and other insurance documents you would otherwise be responsible for providing;
Contacting the selling dealer or another authorized source to request available purchase agreements, buyer's orders, vehicle equipment information, window stickers, build information, or other vehicle-sale documents you would otherwise be responsible for providing;
Organizing documents received through these requests and adding them to your electronic claim file; and
Providing electronic status notifications and notifying you of documents that remain missing or unavailable.

The $24.00 fee compensates the GAP Provider for voluntarily performing these document-retrieval and claim-concierge tasks on your behalf. It is not a fee for filing, investigating, adjudicating, approving, denying, or paying your GAP claim.

Document-retrieval authorization and permission

By selecting this optional service, I expressly authorize and direct the GAP Provider, its claim administrator, and its authorized service providers to contact and request information and documents from my lender, lessor, account servicer, primary motor-vehicle insurer, insurance agent, claim administrator, selling dealer, and other persons or organizations reasonably believed to possess documents relevant to my GAP claim.

I authorize these persons and organizations to release the requested claim-related information and documents to the GAP Provider and its authorized service providers. I authorize the GAP Provider to receive, verify, copy, store, organize, use, and share the information as reasonably necessary to administer, evaluate, resolve, audit, or review my GAP claim and comply with applicable legal and regulatory requirements.

This authorization includes permission to obtain available:

Finance agreements, payoff statements, account balances, payment histories, and financed-product information;
Primary-insurance proof-of-loss documents, total-loss valuations, settlement statements, deductible information, and payment records; and
Vehicle-purchase, equipment, identification, title, registration, and dealer records relevant to the claim.

A photocopy, electronic copy, or electronically signed version of this authorization may be accepted and relied upon as if it were the original. This authorization remains effective until the final resolution of my claim, including any requested reconsideration or appeal, unless I revoke it in writing.

I understand that I may revoke this authorization before the requested services are completed. Revocation will not affect documents previously requested, obtained, or used. If I revoke this authorization, I will be responsible for obtaining and submitting any remaining required documents myself.

Service limitations

Selecting this service may reduce the time and effort required to assemble a complete claim file, but it does not guarantee that a third party will provide a requested document, that the claim will be approved, or that the claim will be completed by a particular date.

Selecting or declining this service will not change my coverage, benefit calculation, claim priority, appeal rights, or any applicable claim-handling deadline. Complete claims are evaluated under the same GAP Agreement terms and claim-handling standards regardless of the submission method selected.

The $24.00 fee will be collected separately and will not be deducted from or reduce any GAP benefit. If the GAP Provider does not initiate the selected document-retrieval services or is unable to obtain at least one requested document, the fee will be refunded.

Customer election — please select one

STANDARD CLAIM SUBMISSION — NO FEE. I will obtain and submit the required documents myself. OPTIONAL DOCUMENT-RETRIEVAL AND CLAIM CONCIERGE SERVICE — $24.00. I voluntarily purchase this service and give the GAP Provider permission to request, receive, and use the claim-related documents described above.

I understand that this optional service is not required to file or pursue my claim and that declining it will not result in a penalty or reduction of benefits.

Customer name (type your full legal name as your signature)

Customer information

First name Last name Phone Email Street address Address line 2 City State ZIP/postal code

Vehicle and loss information

VIN Date of loss Year Make Model Trim Odometer at loss Had active insurance at time of loss? Insurance company Police report available?

What happened?

Describe the total loss incident in detail — what happened, where, and any other information that helps us process your claim. Minimum 200 characters, up to 5,000.

Incident description

Lender / credit union contact

This lets the adjudication team request the book value and supporting loan information directly from the bank when needed.

Lender or credit union name Bank contact name Bank contact phone Bank contact email

Required documents

Driver’s license - front Driver’s license - back Police report, if available Proof of insurance Insurance valuation/evaluation Insurance settlement documents Lender payment history Lender payoff/payment statement Retail installment contract from lender/credit union

Optional supporting uploads

Accident / vehicle photos Book value document from lender/customer, if already obtained

Authorization

I authorize VerifiedGAP and its claim administrators to obtain my driving history / motor vehicle report from state and third-party sources for the purpose of processing this GAP claim. I understand I may receive a separate consent request by email as required by law.

Attachments must total no more than 25MB. Phone photos usually compress well — if you're close to the limit, try fewer or smaller photos, and add extras from your claim dashboard after submitting.

Can't get every document together right now? Use “Save progress” — your answers are stored to your account (you'll be asked to create a free account or log in) and the form will be pre-filled when you come back. Documents are attached at final submission.