Dispute Center

Personal Injury/Property Damage

Date of purchase

Please select a brand for which you are filing a claim.

Please upload any scanned images of documentation that will be needed for the evaluation and processing of your claim request. (i.e. receipt). Click the "Choose File" button to locate the scanned images to be uploaded.

Upload File

Add File

Accepted file types: JPG, PNG, GIF, PDF

[Max upload of 6 MB total]

Store Information:

Store Lookup

Store Name

Store Address

Store City

Store State / Province

Store Zip Code

Product Purchased:

Total Claim Amount Requested:

Incident Information:

Incident Date

Reason for Claim:

Claim Description (Please be descriptive):

* Fields labeled with an asterisk are required