Visible Damage Insurance
Claim Logistics Request
SMO
L:92
Revised:04/2025
Copies of sales receipts must be retained for 120 days.
Boxes marked with an asterisk (*) are required.
Dealer number *
(6 digits)
Dealer Email *
Contact Name *
Contact Phone *
Contact Address *
Carrier *
(select)
Please Select a Carrier
A Duie Pyle
American Fast Freight
Averitt Express
Cal-Cartage
Dayton Freight
Oak Harbor Freight
R and L Freight
Star Freight
T-Force Freight
Tokio Marine
Central Transport
VIN*
Pro # *
(11 digits)
Damage Decription *
Date of Incident
(Select)*
Vehicle Weight
Labor Rate *
#
Damaged Parts
QTY
Labor Time
Action
Add Part
Photos of Damage
Up to 10 files
Shipping Documents (BOL and Delivery Receipt)
Up to 2 files
Clear Form
Submit Claim
Print Page