Your Claim Documents

We know how important your device is to you. To help ensure the security of your device insurance claim and identification, on occasion, we will need additional information.

For fastest processing, you can obtain your claim affidavit by entering your claim ID and phone number below and clicking "PRINT".

Phone Number

(e.g. 1234567890)
Claim ID

(e.g. 12345)

FAQS Questions about the affidavit? click here for help

Download Adobe Reader PDF format requires Adobe Acrobat Reader which is available for free

What Type of Identification Do We Need??

All forms of identification must be legible, unaltered, and legitimate. (Don't draw a mustache on your picture!) If the ID appears altered, forged or not legitimate, we have to get an Asurion Insurance Adjuster to review the claim in its entirety (really slows things down).

Any of the following United States Government issued IDs or a recognized United States educational institution ID is an acceptable form of identification.

  1. Valid Driver's license or Identification Card
  2. Passport issued by any Government.
  3. Visa (green card or alien card)
  4. Military ID
  5. Resident Alien Permit
  6. Matricular Consular

Don't change names on us! If the name on the Identification does not match the name of the person filing the claim and name on the wireless carrier account, then additional information may be required (again, unfortunately slows things down)

What Proof of Warranty Exchange Information Do We Need??

We are able to accept a copy of your Walmart or Carrier receipt/bill of sale showing the purchase of your device or in the case your original device was exchanged under warranty with a different make and model you may include an exchange receipt and/or a packing slip from Walmart, carrier or manufacturer.

Document must list:

  • Date of Purchase or Warranty Exchange
  • Equipment Provider
    • Example:Walmart,manufacturer,carrier(AT&T,VerizonWireless,T- Mobile, Sprint)
  • make and model of device
  • ESN, IMEI or MEID of device

How to Return the Form??

Quick Option: Fax the form to Asurion at 1-877-389-5148

Slow Option: Mail the form and copy of your valid ID to the following address:
Asurion Attn: Review Team (Walmart)
PO Box 413886
Kansas City, MO 64141-3886

After your Claim Affidavit form has been received and processed, a Customer Service Representative will contact to complete your claim. You simply come back here – type in your claim number and you are on the fast track to completion!