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At Xzilon®, we believe filing a claim should be as easy and painless as possible. That’s why we created this simple online form that you can submit electronically through our website. To ensure quick service, please be sure all information is complete and accurate. If you have any questions, feel free to call our toll-free claims hot-line at 877.808.4649. One of our knowledgeable claims representatives will be glad to assist you.

Claim Form

All fields are * required.

Section 1: Contact information

I am the: * Customer Service Advisor

Enter the customer information below

Name: *

Current Address: *

City: *

State: *

Zip Code: *

Phone: *

Email: *

Contact Preference:

Section 2: Vehicle information
VIN: *

Make: *

Model: *

Year: *

Xzilon® warranty number:

Car Mileage *

Section 3: Claim description information
Select Damage Type: *
Damage location: *
Damage Date: *

Detailed Damage Description: *

Section 4: Submission


Please read the following statements carefully. Claims will not be processed unless the full name of the claimant has been provided.

Please type your full name below to indicate:

I am aware that Xzilon® relies on the information and statements above. I hereby certify that the above statements are complete and accurate to the best of my knowledge. I understand that any inaccurate information entered on this form could affect the outcome of the claim, including denial of claim.

Please note that it will take up to 24 hours to process an online claim.

Signature: *




Telephone & email

Corporate: 800.553.6866

Email: info@xzilon.com

Claims: 877.808.4649

Email: claims@xziloninc.com


Xzilon, Inc., 63056 Lower Meadow Drive, Suite 100 | Bend, OR 97701

Xzilon, Inc., 1537 92nd Lane NE, Suite A | Blaine, MN 55449

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