• * Enter your Member ID

  NOTE: Your Member ID is NOT your SSFCU Member number, CIS, or checking account number. Your Member ID can be found in your Power Protected ID Monitoring account. How can I find my Member ID?

Policy / Device Information

• * Device Type

  Cell Phone
  * Device Make
• * Device Model
  * Device Serial Number

Claim Information

• * Date of Loss
  * Type Of Loss

  Please Select...Accidental DamageCorrosion and RustCosmetic DamageCracked ScreenElectrical BreakdownFireFloodIntentional ActsLiabilityLightningLiquidMechanical BreakdownMysterious DisappearanceNatural DisasterNuclear HazardPower SurgeSeizureTheftTheft From Unattended VehicleVandalismWater DamageWear & TearWind Damage

• Police Report (Fire)

• Police Report (Theft)

• Police Report (Vandalism)

• * Date of Police Report
  * Officer First Name
• * Officer Last Name
  * Officer Contact Number
• * Report/Case #
• * Description of Incident
  * Known Damage to the Unit

Contact Information

• * First Name
  * Last Name
• * Email Address
  * Phone
• * Address Line 1
• Address Line 2
• * City
  * State

  Please Select...AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
• * Zip

Disclaimer & Digital Signature

• * 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.

   

• * Check this box to acknowledge that you have read and agree to the above Disclaimer

  • I Agree
    Please read and agree to Disclaimer

  Please read and agree to Disclaimer