File a New Labor Claim

Towing cost are not covered under Federated Labor Assurance Program claims. Please file a Roadside Assistance claim for towing.

* required field

Claimant Contact Information

Claimant Name*

Claimant Phone*

(example: 1234567890)

Vehicle Owner Information

Vehicle Owner First Name*

Vehicle Owner Last Name*

For claim verification purposes only. Vehicle owner will never be contacted.

Vehicle Information

Vehicle Year*

Vehicle Make*

Vehicle Model*

Claim Information

Original Repair Invoice Number*

Original Repair Date*

Original Repair Mileage Reading*

Warranty Repair Invoice Number*

Warranty Repair Date*

Current Mileage Reading*

Repair Information

Labor Charge Per Hour*

Original Repair Labor Hours*

Original Repair Labor Charge*

Warranty Repair Labor Charge*

Repair Category*

Part Failure Description*

Files

Please upload the following files:

Original Repair Invoice/Work Order

Original Repair Parts Purchase Receipt

Warranty Repair Invoice/Work Order

Warranty Repair Parts Purchase Receipt


Click here if you prefer to fax your documents to us.

Please fax to 866-658-1246 with the subject line "Federated Labor Assurance Program Claim".


Original parts and these documents must be returned to the original Federated servicing location.

Contact Name:
{CONTACT_FIRST_NAME} {CONTACT_LAST_NAME}
Business Name:
Business Address
{BUSINESS_ADDRESS}
Business City
{BUSINESS_CITY}
Business State
{BUSINESS_STATE}
Business Zip
{BUSINESS_ZIP}
Business Phone:
{BUSINESS_PHONE}
Business Fax:
{BUSINESS_FAX}
Business Email:
{BUSINESS_EMAIL}
District:
{DISTRICT_NAME}
Preferred Method to Receive Payment:
{PREFPAYMENT}
Contact First Name:
Contact Last Name:
Business Name:
Business Address
Business City
Business State
Business Zip
Business Phone:
Business Fax:
Business Email:
District:
Preferred Method to Receive Payment: