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GAP Claim Information Form

It will take two business days to process your information. When you are ready to begin, proceed below.

Are you filing this claim as a resident of the state of Texas?

YesNo
Date of Loss
Agreement Number
First Name
Last Name
Address
City
Zip
Email Address
Phone Number
Vehicle Identification Number

Insurance Information

Company Name
Adjuster
Company Phone
Claim Number

Lender/Finance Company

Institution Name
Account Number
Address
City
Zip
Phone Number

Type of Loss

If other, please describe here.
Mileage at Loss
This is some text inside of a div block.

Thank you! Your submission has been received!

Oops! Something went wrong while submitting the form

Once you've completed and submitted the form above, the next step is to click the link below to submit the required documents.
mygapclaim@jmagroup.com

Send any or all information immediately as there is a time restriction in which to submit your GAP Claim. You must submit the completed claim information form within ninety (90) days of the Total Loss Settlement or within ninety (90) days from the Date of Loss if the vehicle is not insured, whichever is later, or your claim will be denied.

If you would like to print and submit this form manually, you can download it here.

Date of Loss
Agreement Number
First Name
Last Name
Address
City
Zip
Email Address
Phone Number
Vehicle Identification Number
Addendum Number
Details of use...

Insurance Information

Company Name
Adjuster
Phone Number
Claim Number
Vehicle Location

Lender/Finance Company

Institution Name
Account Number
Address
City
Zip
Phone Number

Type of Loss

If other, please describe here.
Mileage at Loss

Thank you! Your submission has been received!

Oops! Something went wrong while submitting the form

Once you've completed and submitted the form above, the next step is to click the link below to submit the required documents.
mygapclaim@jmagroup.com

Send any or all information immediately as there is a time restriction in which to submit your GAP Claim. You must submit the completed claim information form within ninety (90) days of the Total Loss Settlement or within ninety (90) days from the Date of Loss if the vehicle is not insured, whichever is later, or your claim will be denied.

If you would like to print and submit this form manually, you can download it here.

State Fraud Notification

How can we help you?

General

How does JM&A Group value my vehicle?
How do I cancel non-GAP F&I products that are no longer valid due to a total loss (service contracts, maintenance plans, etc.)?
What can I do to help the claims process move as quickly as possible?
How do I stay up to date on the status of my claim?
What is GAP?

First Steps

I have GAP protection and my vehicle was totaled. What should I do?
Do I need to continue making my Finance Contract payments while my claim is being processed?
What are the documents needed to process a claim and where do I get them?
What’s the best way to submit my documents?
How quickly should I open a claim?

Claim Process

Who’s responsibility is it to gather the claim documents?
Once I submit the required documents, how long will it be until they are associated with my claim?
How long does it take to process my GAP claim?
How do I withdraw an active GAP claim?

Coverage

I refinanced my loan; do I still have GAP coverage?
Is there a maximum limit on coverage?
What happens if I don’t have automobile insurance?
Does GAP have a deductible?
CLOSE  X
Lender Name*
Email Address*
Customer Last*
Customer First*
Customer VIN*
Customer Last
Customer First
Customer VIN
Customer Last
Customer First
Customer VIN
Customer Last
Customer First
Customer VIN
Customer Last
Customer First
Customer VIN
Thank you! Your submission has been received! A JM&A representative will be in contact with you soon.
Oops! Something went wrong while submitting the form.
CLOSE  X
First Name*
Last Name*
Email Address*
Addendum Number (Up to 12 Digits)*
Thank you!
Your submission has been received! A JM&A representative will be in contact with you soon.
Oops! Something went wrong while submitting the form.