ClaimShare Cooperative Claim Submission/Benefit Request Form

ClaimShare Cooperative Claim Submission/Benefit Request Form
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Vehicle Details

Which vehicle was damaged?
Vehicle Make*
Vehicle Model*
Model Year*
VIN*
Claim Details
Turo Claim Number*
Who Is Your Turo Claim Rep?*

First NameLast Name
Upload a screenshot of the email from your claim rep identifying the vehicle, the Turo claim payout, and the deductible applied to your payout.*

Cancelof
Amount Requested From ClaimShare Cooperative*
Amount requested must be equal to or less than your currently accrued benefits available.
I have uploaded a screenshot of the claim settlement email from my Turo claim rep above.I have forwarded the claim settlement email from my Turo claim rep to admin@claimsharecoop.comI have checked my ClaimShare Cooperative dashboard and verified that the amount I am requesting is equal to or less than my currently available benefits.I understand that the Turo claim information I have submitted will be verified with Turo.I understand that falsifying a Turo claim to request benefits will result in the cancellation of my ClaimShare Cooperative membership.
Sign Your Benefit Request Submission*

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What Happens Next

Once your benefit request form is submitted the following process will begin:

1. Turo claim information will be validated.

2. Verification of currently available benefits.

3. Once approved, benefit payment will be sent via your preferred payment method within 72 business hours.
Should be Empty:

ClaimShare Cooperative Claim Submission/Benefit Request Form

Vehicle Details

Claim Details