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    507351144662 9

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    munchee35
    This document provides instructions for submitting a claim for device loss or damage through Verizon, detailing the necessary steps for online and fax submissions. It emphasizes the importance of including a valid photo ID and ensuring all documents are clear to avoid processing delays. Additionally, it warns against insurance fraud and outlines the consequences of providing false information in support of a claim.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    507351144662 9

    Uploaded by

    munchee35
    1 views2 pages
    This document provides instructions for submitting a claim for device loss or damage through Verizon, detailing the necessary steps for online and fax submissions. It emphasizes the importance of including a valid photo ID and ensuring all documents are clear to avoid processing delays. Additionally, it warns against insurance fraud and outlines the consequences of providing false information in support of a claim.

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    Sa duhuma

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    This document provides instructions for submitting a claim for device loss or damage through Verizon, detailing the necessary steps for online and fax submissions. It emphasizes the importance of including a valid photo ID and ensuring all documents are clear to avoid processing delays. Additionally, it warns against insurance fraud and outlines the consequences of providing false information in support of a claim.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    1 views2 pages

    507351144662 9

    Uploaded by

    munchee35
    This document provides instructions for submitting a claim for device loss or damage through Verizon, detailing the necessary steps for online and fax submissions. It emphasizes the importance of including a valid photo ID and ensuring all documents are clear to avoid processing delays. Additionally, it warns against insurance fraud and outlines the consequences of providing false information in support of a claim.

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    © All Rights Reserved
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    DO NOT FAX THIS PAGE

    How to Submit the Required Documentation


    The person completing this document must be a Verizon Account Manager/Authorized user and must provide a copy of their vaild photo ID.

    Choose an option (Online or Fax) and follow the steps

    Online (Recommended)

    1 Print, fill out and sign the Sworn Affidavit & Proof of Loss Statement.
    Found on page 2 of this document.

    2 Scan or take pictures of both the completed Sworn Affidavit & Proof of Loss Statement and your valid photo ID.
    Acceptable forms of photo ID: valid driver’s license, passport, State DMV-issued ID card or matricula consular ID.

    3 Upload both documents at phoneclaim.com/verizon-uploader

    Fax

    1 Print, fill out and sign the Sworn Affidavit & Proof of Loss Statement.

    2 Photocopy your valid photo ID and write your Verizon Wireless number on each page.

    3 Fax both documents to 1-877-595-1399.

    How to prevent delays in processing your claim

    The Sworn Affidavit & Proof of Loss Statement is marked with a barcode that is specific to your claim. Using a photocopy with an incorrect
    barcode will delay your claim. Make sure you have a valid photo ID.
    • Acceptable forms of photo ID: valid driver’s license, passport, State DMV-issued ID card or matricula consular ID. ID must not be expired
    • Unacceptable forms of photo ID: student ID, work ID, birth certificate, Social Security card, Military IDs and expired IDs
    • Name on the ID must match name of the Account Owner who completes and signs the Sworn Affidavit & Proof of Loss Statement
    • If name does not match, then you may need to provide additional documentation
    • If the ID appears altered, forged, illegitimate or unreadable, we will not be able to proceed with your claim
    Make sure all document scans or faxes are clear and easy to read
    • When making the photocopy of your photo ID, consider using the enlarge and contrast settings to make the ID easier to read
    • Color copies are preferred

    Please return all documents and complete your claim within 180 days. After this period, your claim will be canceled and you may not be able to refile your claim.
    Questions? Call us at 1-888-881-2622.

    How to find your device manufacturer, model and ESN/MEID/IMEI

    For Apple products: For Android products: For most devices:


    • Open iTunes • Log in to google.com/dashboard Find this information on:
    • Choose iTunes > Preferences in Mac OS X • Click the Android section to display • Back of the phone/device or under the battery
    (not all batteries are accessible)
    • Choose Edit > Preferences in Windows ESN/MEID/IMEI
    • Click the Devices tab • Your Customer Agreement (available at verizonwireless.com)
    • The box the phone/device came in
    • Position the mouse over “Backup Device”
    to display ESN/MEID/IMEI • If none of these are available please contact Verizon Wireless

    Verizon’s device protection program includes Wireless Phone Protection (WPP), which is insurance coverage underwritten in Georgia by LM General Insurance Company (Boston, MA),
    in Indiana by Indiana Insurance Company (Boston, MA), in Louisiana by Liberty Personal Insurance Company (Boston, MA), in New Jersey by Liberty Mutual Mid-Atlantic Insurance
    Company (Boston, MA), and in all other states, Liberty Insurance Underwriters Inc. (Boston, MA) or one of its insurance company affiliates. Asurion Insurance Services, Inc. (in California,
    Agent License #OB35141; in Iowa, Agent license #1001000131), is the Agent and provides the claims servicing under this program.
    Sworn Affidavit & Proof of Loss Statement
    The person completing this document must be a Verizon Account Manager/Authorized user and must provide a copy of their vaild photo ID.

    INSURANCE FRAUD IS A CRIME

    I understand that presenting false information in support of this claim with the intent to injure, defraud,
    or deceive is a crime. Asurion may take legal action and report to law enforcement when it suspects
    fraud in the presentation of a claim.

    What device are you claiming? ALL FIELDS ARE REQUIRED. PLEASE PRINT USING BLUE OR BLACK INK

    Wireless Number:

    Manufacturer: Model:
    ( Examples: Samsung, LG, Motorola, etc. ) ( Examples: iPhone 12, Galaxy S21 , Moto G, etc.)

    ESN/MEID/IMEI:
    ( Refer to the instructions on the previous page )

    What happened to the device?

    My Device Is: Lost Stolen Damaged Malfunctioning

    Date of Occurrence: Place of Occurrence:

    Describe What Happened:

    Note: If your device was damaged or malfunctioning, you are required to return it to Asurion upon receipt of your replacement.

    Account Owner information

    Full Name:

    Contact Number: Alternate Contact Number:

    Email Address:

    Billing Address:

    City: State: Zip Code:

    Affirmation

    I hereby make an insurance claim against the insurance company as shown on this insurance claim affidavit. I acknowledge that if any property which is the subject of
    this claim and which is replaced or paid for by the insurer is recovered at any time, it is the property of the insurance company and must be returned to the insurance
    company. I understand that if I fail to return such property, I am subject to, and authorize a non-return fee of up to $300 to be charged under the insurance policy using
    the method of payment used to originally file this claim.

    I swear/affirm that the device I am claiming is owned by me and that the information provided above is true and accurate. I understand that presenting false information in support of
    this claim with the intent to injure, defraud, or deceive is a crime. Asurion may take legal action and report to law enforcement when it suspects fraud in the presentation of a claim.

    Signature: Date:

    Web: phoneclaim.com/verizon-uploader Fax: 1-877-595-1399


    Control # COV55412 Rev 2 EDT: 05/2020 RDATE: 04/2023
    Asurion Attn: Review Team P.O. Box 332024 Nashville, TN 37203-7519

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