INSTRUCTIONS:

  1. Complete and sign this claim form. Your signature is required for processing.
  2. Attach a copy of your original invoice billing your customer for this shipment.
  3. Attach a copy of an email or signed letter from the package recipient advising you of the loss or damage.
  4. Submit this claim form WITH ITEMS 2 & 3 above using the information to the right.

Send this claim form PLUS items 2 & 3.

Email:

or Mail:

Fax:

claims@pipinsure.com

Parcel Insurance Plan

PO Box 66708

St. Louis MO 63166-6708

314-692-7598

Important Notes:

  1. You must wait 30 days after the shipment date to submit a claim for a LOST package. Claims for DAMAGED packages can be submitted at any time. All claims must be submitted within 90 days of the shipment date.
  2. The package recipient should hold damaged items in the event they are requested during claims processing. FAILURE TO RETAIN DAMAGED PROPERTY COULD AFFECT FINAL SETTLEMENT OF THE CLAIM.
  3. Warning: Any fraudulent claims will make the shipper and/or package recipient liable for prosecution for mail fraud under the Federal Criminal Code.
  4. Call PIP directly with questions or if PIP has not responded to your claim within 3 weeks of filing at 800-325-7390 (ext 311).

CLAIM INFORMATION

Package Recipient’s Name:

Shipment Date:

Customer ID:

Tracking/Confirmation #:

Claim Type: [   ] LOST [   ] DAMAGED [   ] SHORTAGE

Description of Items:

Amount of claim (invoice or repair cost excluding shipping fees)

Less amount paid by USPS, if any

Less salvage value of DAMAGED goods (this does not apply if package is LOST)

Balance to be paid by PIP

Shipper’s Contact Information

Shipper’s Name:

Send check to attention of:

Shipper’s Mailing Address:

City, State, Zip:

,

Telephone:

Email Address:

I certify that the above statements are correct.

Signature:

FOR PIP USE ONLY

AMOUNT: $____________________

DATE: _________ BY: ___________