File a Claim

Remember, claims should only be submitted on phones that are active as shown on your mobile device wireless bill for the previous month.

Incidents for accidental damage and mechanical failure that occur prior to, or in the 30-day waiting period are not covered.

Policy / Device Information

Claim Information

Police Report (Fire)

Police Report (Theft)

Police Report (Vandalism)

Contact Information

Enter the name and address of the person we should contact.

Certification Statements

Disclaimer & Digital Signature


We must advise you that any person who knowingly and with intent to defraud any insurance company files a statement of claim containing any materially false information, or conceals for the purpose of misleading information concerning any fact thereto, commits a fraudulent insurance act, which is a crime and may be prosecuted to the full extent of the law. By signing, I agree that the statements above are true and correct to the best of my knowledge and cannot be changed once submitted to the company.




Worth Ave. Group - Providing peace of mind to consumers for over 50 years.
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