GAP Claim Form
Borrower Information

Borrower Name:
Address:
Address Cont:
City, St Zip: 
select
 
Phone:
Email:
 Vehicle Information

Vehicle Year:
Vehicle Make:
Vehicle Model:
VIN:
Dealership:

Type of Loss:
Date Theft Occurred:
Please upload a copy of the following documents by clicking on the buttons below. If you do not have copies of these documents your dealership, lender or insurance company can assist you. Please note we may require additional information to resolve your claim.
Details of Loss / Comments:
FRAUD STATEMENT: It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance, and civil damages. It is a crime, subject to penalties that include imprisonment and/or fines, for any Person who knowingly makes or knowingly assists, abets, solicits or conspires with another to make a false report of the theft, destruction, damage or conversion of any type of motor vehicle to a law enforcement agency, program administrator or an insurance company.

I understand that my claim will fully be investigated and that all statements and representations made by me are in fact true. By submitting this claim, I acknowledge that no material facts are withheld of which the insurer should be informed.
It will take 7-10 business days to review your claim once we have received all of the documentation needed. We will send a settlement statement to you and to your lender. All settlement checks will be sent directly to your lender. We recommend that you continue to make your monthly payments, as charges to your account after the date of loss (such as interest and late charges) are not covered by GAP. Late payments may reflect negatively on your credit.

Yamaha Financial Services | (866)488-2347 | ygap@yamaha-motor.com

Hours of Operation: Monday–Friday, 7:30am-4:00pm (PT)