submit
claim

Claim Submission Confirmation

Your claim has been successfully submitted and an email has been sent to {{CustomerInfo.EmailAddress}} from keys@agero.com. You can check on the status of your claim at any time by using the Claim Status feature. You will need your zip code, and one of the following: Claim ID number, phone number or the last 8 digits of your VIN.

Your claim has been successfully submitted and an email has been sent to {{CustomerInfo.EmailAddress}} from tireandwheel@agero.com. You can check on the status of your claim at any time by using the Claim Status feature. You will need your zip code, and one of the following: Claim ID number, phone number or the last 8 digits of your VIN.

Your claim has been successfully submitted and an email has been sent to {{ClaimInfo.DealerEmail}} from keys@agero.com. You can check on the status of your claim at any time by using the Claim Status feature. You will need your zip code, and one of the following: Claim ID number, phone number or the last 8 digits of your VIN.

Your claim has been successfully submitted and an email has been sent to {{ClaimInfo.DealerEmail}} from tireandwheel@agero.com. You can check on the status of your claim at any time by using the Claim Status feature. You will need your zip code, and one of the following: Claim ID number, phone number or the last 8 digits of your VIN.

Claim ID: {{ClaimId}}
Claim Submitted: {{ ClaimSubmittedDateTime | date:"MM/dd/yyyy 'at' h:mma"}}
Print Email

1. Vehicle Information

Full VIN: {{VehicleInfo.VIN}}
Vehicle Make: {{VehicleInfo.Make}}
Vehicle Model: {{VehicleInfo.SelectedModel}}
Vehicle Year: {{VehicleInfo.SelectedYear}}
Membership Number: {{VehicleInfo.ContractNumber}}
Service Contract Provider: {{VehicleInfo.ContractProvider}}

2. Service Performed

Service Performed: {{ServicePerformedInfo.Service}}
Mileage: {{ServicePerformedInfo.Mileage | number}}
Serviced Tires: {{ServicePerformedInfo.SelectedWheels.join(", ")}}
Damage Tire Tread Depth: {{ServicePerformedInfo.DamageTreadDepthCollection}}
Total Services Cost: ${{(ServicePerformedInfo.TotalCost) | number:2}}
Total Anticipated Reimbursement Value: ${{(ServicePerformedInfo.TotalAnticipatedCost) | number:2}}

3. Customer Information

First Name: {{CustomerInfo.FirstName}}
Last Name: {{CustomerInfo.LastName}}
Phone Number: {{CustomerInfo.PhoneNumber}}

4. Claim Information

Repair Order Number: {{ClaimInfo.RepairOrderNumber}}
Date of Loss: {{ClaimInfo.LossDate | date:'MM/dd/yyyy'}}
Date of Service: {{ClaimInfo.ServiceDate | date:'MM/dd/yyyy'}}
Description of the Damage and/or Loss:

{{ClaimInfo.LossDescription}}

Supporting Documentation:

{{ClaimInfo.File1Upload}}

{{ClaimInfo.File2Upload}}

{{ClaimInfo.File3Upload}}

I am a: {{ClaimInfo.UserType}}
Best Time to Contact Me: {{ClaimInfo.BestTimeToCall}}
Dealership Phone Number: {{ClaimInfo.DealerPhoneNumber}}
Dealership Name: {{ClaimInfo.DealerName}}
Dealership Contact Name: {{ClaimInfo.DealerContactName}}
Dealership Email Address: {{ClaimInfo.DealerEmail}}
Dealership ZIP Code: {{ClaimInfo.DealerZIP}}
Dealership Country: {{ClaimInfo.DealerCountry}}
Payment To: {{ClaimInfo.PaymentTo}}
Preferred Payment Method: Check
Preferred Payment Method: {{ClaimInfo.PreferredPayment}}
Notification Email Address: {{ClaimInfo.EmailAddress}}
Payee Mailing Address:
Customer Mailing Address:

{{ClaimInfo.PayeeStreet}}
{{ClaimInfo.PayeeCity}}, {{ClaimInfo.State}} {{ClaimInfo.PayeeZIP}} {{ClaimInfo.Country}}

Payee Mailing Address:
Customer Mailing Address:

{{ClaimInfo.PayeeStreetNo}}
{{ClaimInfo.PayeeCity}}, {{ClaimInfo.State}} {{ClaimInfo.PayeeZIP}} {{ClaimInfo.Country}}

Payee Mailing Address:
Customer Mailing Address:

{{ClaimInfo.PayeeStreetNo}}, {{ClaimInfo.PayeeStreet}}
{{ClaimInfo.PayeeCity}}, {{ClaimInfo.State}} {{ClaimInfo.PayeeZIP}} {{ClaimInfo.Country}}

Payee Mailing Address:
Customer Mailing Address:

{{ClaimInfo.PayeeCity}}, {{ClaimInfo.State}} {{ClaimInfo.PayeeZIP}} {{ClaimInfo.Country}}

Email Address: {{ClaimInfo.CustomerEmailAddress}}
Customer Mailing Address:

{{ClaimInfo.PayeeStreet}}
{{ClaimInfo.PayeeCity}}, {{ClaimInfo.State}} {{ClaimInfo.PayeeZIP}} {{ClaimInfo.Country}}

Customer Mailing Address:

{{ClaimInfo.PayeeStreetNo}}
{{ClaimInfo.PayeeCity}}, {{ClaimInfo.State}} {{ClaimInfo.PayeeZIP}} {{ClaimInfo.Country}}

Customer Mailing Address:

{{ClaimInfo.PayeeStreetNo}}, {{ClaimInfo.PayeeStreet}}
{{ClaimInfo.PayeeCity}}, {{ClaimInfo.State}} {{ClaimInfo.PayeeZIP}} {{ClaimInfo.Country}}

Customer Mailing Address:

{{ClaimInfo.PayeeCity}}, {{ClaimInfo.State}} {{ClaimInfo.PayeeZIP}} {{ClaimInfo.Country}}

Email Address: {{ClaimInfo.CustomerEmailAddress}}
Note
  • Claims will not be processed until final copy of the repair order with full breakdown of the charges is received
  • It will take 7-10 business days to review and process claim