Titan Auto Glass Claims Form - Titan Auto Glass

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone

Vehicle Year

Vehicle Make

Vehicle Model

Type (if applicable)

Heated Windshield

Rain Sensor

ADAS

Lane departure

Forward warning collision

Not Sure

VIN #(Required)

Insurance Company and Policy #

Date of Loss

Cause of Loss

Damage Location

Quarter glass: a triangular or rectangular piece of glass that’s found on the sides of the vehicle towards the rear.

Vent glass: a small triangular piece of glass found on the door.

Additional information (i.e. work to be done at different location; special request)

Name

This field is for validation purposes and should be left unchanged.

Response Times

Our response time is dependent on when the information is submitted.

During business hours: < 2 Hours
Outside of business hours: < 1 Business Day

No insurance?

No problem. At Titan Auto Glass, we understand that everyone’s situation is different.
We work with our clients to offer payment solutions that fit their situation.

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