Claims Form – Wash UP

All claims will be reviewed and validated using available camera footage to confirm the date and time of the reported incident. We do not process claims for cars over 10 years old and 100,000 miles. Claims submitted more than seven (7) days after the date of the incident will not be processed. Claims submitted without accompanying photographic evidence will be considered incomplete and will not be processed.

Vehicle Damage Claim

Damages Claim

Name(Required)

First Last

Phone(Required)

Vehicle Type(Required)

Vehicle Color(Required)

Vehicle Year(Required)

Vehicle Miles(Required)

License Plate Number(Required)

Date of Incident(Required)

Time of Incident(Required)

Location of Incident(Required)

Description of Incident(Required)

Photos ( Please include photos of all sides of your vehicle )(Required)

Drop files here or

Max. file size: 64 MB.

All claims will be reviewed and validated using available camera footage to confirm the date and time of the reported incident.
Please allow up to 3–4 weeks for the processing of claims.
Claims submitted more than seven (7) days after the date of the incident will not be processed. Claims submitted without accompanying photographic evidence will be considered incomplete and will not be processed.

CAPTCHA

Phone

This field is for validation purposes and should be left unchanged.