Submit A Claim

Service Options

Today's Date

Requested Service

Failure Analysis

ID Only

Express Report

Storage Only

Do you need DPI to arrange pickup of item?

Yes

No

Shipping Assistance

Send box and label

Email a label

After completion of report

Store item

Return item

Item will be returned upon payment of invoice.

Can we contact your insured if we need additional information?

Yes

No

Claim Value

Reports will be emailed to the submitting party unless otherwise directed.

Submitting Party & Claim Information

Claim #

Submitting Party's Name

Company Name

Billing Address - No P.O. Box Numbers

Submitting Party's Phone

Submitting Party's Email

Insured's Name

Insured's Address - No P.O. Box Numbers

Insured's Phone

Insured's Email

Information Pertaining to Evidence Involved in Claim

Type of Product

Where was item used?

Model Number

Serial Number

Date of Loss

Date Installed

Manufacturer

Are there receipts? Upload copy if possible

Yes

No

Circumstances/details involving claim

Upload supporting documents or photos

Upload on-site photos, cause and origin reports, receipts, or other pertinent information. Selected files will be displayed below the upload field after they are uploaded successfully.

By submitting this form, I acknowledge that I have read and agree to the DPI Storage Agreement and Liability Statement.

View Statement

Product Inspection and Investigation Center (dba) DPI

Supporting insurers, adjusters, attorneys, and subrogation professionals nationwide.

Complete the form below to request product failure analysis, manufacturer identification, evidence storage, or related services.

All inspections, where possible, include identification of the manufacturer/distributor.

Service Options

Submitting Party & Claim Information

Information Pertaining to Evidence Involved in Claim