Recover My Value – Free Diminished Value Check

1

Name* This field is required.What’s your full legal name? Please enter the name of the person who owned the vehicle at the time of the accident.

First Name

Last Name

2

Contact* This field is required.Best email to reach you about this claim

example@example.com

3

Claim Document UploadAlready filed a claim? Just upload the claim information here, and we'll extract the information for you. While we maintain utmost confidentiality, please refrain from including any sensitive personal information (e.g. ss#), as we don't need it.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

4

Are you still the current owner of the vehicle?

YESNO

5

Current Owner's Name

6

Phone NumberBest phone to reach you about this claim

Area Code

Phone Number

7

What’s your vehicle’s VIN?Usually found on your insurance card, registration, or windshield.

8

Date of Loss/Accident

9

Mileage at Date of Loss/Accident

10

Was this the first accident involving this vehicle?

YESNO

11

Has your vehicle already been repaired?

YESNO

12

Upload repair estimate or cost

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

13

Was another driver found at fault for the accident?

Yes

No

14

What insurance does the at-fault person have?

15

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