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File a Claim

Welcome to the Simoniz Online Claim System!

You can file a claim online by simply completing the entire form below or you can email all the information to claims@simoniz.com

If you have any questions related to the claims process please call: (833) 539-1660

Please tell us about yourself: (* denotes required fields)

Name *
Warranty Number *
Address *
Address 2
City *
State *
Zip *
Phone Number *
Email Address *

Vehicle Information

Where was the vehicle purchased? *
Year *
Make *
Model *
VIN# *
Uploading your photos of the damaged area for your claim can expedite the claim process. *
Maximum Total File Size: 20mb
Allow Files: png, jpg, jpeg, bmp, pdf, gif, zip

Claim Information

Damage Area / Claim Type *
Date of Occurrence: *
Description of Damage *
Correction Attempts *
Please upload estimate with vehicle identification number (VIN) *

Dealer Information

If this is a dealership completing the form, please supply the following:

Dealership Name:
Contact at Dealership:
Dealership Phone Number:
Dealership Representative Email Address: