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Submit a Claim

Use this form to start claim intake and upload supporting documents securely. You will receive a claim reference number.

Secure uploads
Documents are uploaded to a private storage bucket. This MVP validates file size and content type on the server.
Status tracking
Use your claim reference and email to check the current status.
Do not include payment card data. This MVP uses hosted payment links only.
Track claim status

Enter your claim reference and the email used during submission.