FREE DIMINISHED VALUE ASSESSMENT

FREE DIMINISHED VALUE ASSESSMENT
Your Information
Full Name*
Email*

Confirmation Email
Phone Number*
Please enter a valid phone number.
Address*
Your Vehicle Information
Year*
Make*
Model*
VIN Number*
17 Characters (this is important or we wouldn't ask)
Trim Level*
(EX, LX, S, XLT, M3, SR5, Etc.)
Doors*
Top*
Transmission*
Miles at Time of Loss*
Please use the mileage on your Auto Body Estimate. If you just give us an approximation, the estimate MAY not be CONSIDERED accurate.
Date of Loss*

MonthDayYear
The date the accident happened
Prior Accident?*
Additional Damage Comments
Using the scale below, please rate your vehicle's pre-loss condition (before the accident). Please be conservative in your ratings as an accurate rating is more credible than an exaggerated rating. (if the vehicle has ANY rock chips, a small parking lot ding, tires that are more than 1 year old, etc. then it is NOT EXTRA CLEAN)
Please Rate Your Vehicle's Pre-Loss Condition*

EXTRA CLEAN - Appears like new for the model year with no visible signs of physical wear. All parts are original and in place. The interior should smell fresh and there should be no tears or stains. It should be mechanically correct with all fluids clean and changed according to the prescribed maintenance schedule. Tires should be like new and completely matching, including the spare.CLEAN - Very little interior or exterior wear. The vehicle is 100% mechanically sound. Any paint repair is almost unnoticeable. All tires should fully match and have good to excellent tread.AVERAGE - The vehicle is solid with substantial serviceable life remaining, but normal interior and exterior wear is allowable. Any previous paint repair must only be apparent to the trained eye. There could be minor mechanical or maintenance work required. Tires should be in average condition or better.ROUGH - The interior and exterior will show more than normal and expected wear and tear. The vehicle could be approaching the end of its serviceable life. The vehicle could have had previous body damage with possible sub-par repairs. There could be cracked glass. The interior could be torn, stained and have adverse odors. There could be physical or mechanical repairs needed. Tires could be worn and/or mismatched.BELOW ROUGH - The interior and exterior will show more than normal and expected wear and tear. The vehicle could be approaching the end of its serviceable life. The vehicle could have had previous body damage with possible sub-par repairs. There could be cracked glass. The interior could be torn, stained and have adverse odors. There could be physical or mechanical repairs needed. Tires could be worn and/or mismatched. The vehicle has a Negative history, frame/structural damage and/or repairs or any mileage discrepancy (True Miles Unknown) would push condition to Below Rough condition. Your vehicle would normally not quality for a diminished value claim.
Claim Information
State the Loss/Accident Occurred in.*
Insurance Company Claim is Against
Were You At Fault?*
Did Any Air Bag(s) Deploy?*
This includes front airbags, side curtains, side impact airbags, etc.
Point of Impact*

Front CenterFront RightFront LeftSide Front Right FenderSide Front Left FenderSide Front Right DoorSide Front Left DoorSide Rear Right DoorSide Rear Left DoorSide Rear Right FenderSide Rear Left FenderRear RightRear LeftRear CenterRoofBottom of Vehicle
Have the repairs been completed on your vehicle?*

YESNO, ETA 2 weeks or lessNO, ETA 2 weeks to 1 MonthNO, ETA more than 1 Month
Please upload the ESTIMATE OF RECORD WITH SUMMARY (PDF form preferred)
Can't upload your estimate for some reason?

Please email the repair bill to:

mail@example.com

Include your name and phone number used in this form in the Subject Line.

EXAMPLE

Subject: ESTIMATE John Smith 503-555-1212
Gross Total Cost of Repairs
This will be on the Final Repair Bill
If you do not upload an estimate, your appraisal will be based solely on the cost of repairs.

This is for a free Estimate only. Please allow at least one business day for an appraiser to review your case and provide you with an estimate as to your loss in value.

You will be provided instructions when you receive your estimate as to how to proceed to purchase your appraisal if you choose to move forward.
Should be Empty:

FREE DIMINISHED VALUE ASSESSMENT

Your Information

Your Vehicle Information

Claim Information