Get in touch
555-555-5555
mymail@mailservice.com
Contact us
Office
2002 W Skelly Dr,
Tulsa, OK 74107
FAX# 918-947-8854
Contact us at:
claims@fivestarassurance.com
Five Star Assurance Benefit Reimbursement Request Form
benefit reimbursement request form
Please either fax reimbursement form and receipts to 918-947-8854, email form and receipts to claims@fivestarassurance.com or mail to 2002 W Skelly Dr. Tulsa, OK 74107
¹ We will Not reimburse for: tires with less than 3/32 tread depth; tires on vehicles other than passenger cars, trucks or vans; any tire covered by manufacturer’s warranty; manufacturer recall or replacement programs; spare tires; cost of balancing or alignment of tires; replacement due to wheel or rim defects or leaks; vandalism, theft, fire or factory defects; used tire replacements. Reimbursement is limited to $100.00 per occurrence with a maximum reimbursement of $400.00 or 4 occurrences within 60 months from date of purchase. ²Tow reimbursement is limited to $50.00 per occurrence with a maximum of 4 occurrences or $200.00 within 60 months from the date of vehicle purchase. ³Roadside assistance is limited to $100.00 per occurrence with a maximum of 4 occurrences or $400.00 within 60 months from the date of vehicle purchase. Benefits are non-transferrable, receipts and supporting documentation must be provided with reimbursement form. Reimbursement requests must be submitted within 30 days of occurrence. All reimbursement requests are subject to review. Dealer may cancel or change benefits program at any time without prior notification.
Your membership to Five Star Assurance program provides you a wide variety services and rewards. Please send Your Claims to: 2002 W Skelly Drive Tulsa, OK 74107 or Fax Number (918)512-4828 or claims email: claims@fivestarassurance.comNew Paragraph
2002 W Skelly Dr.
Tulsa, OK 74107
Fax# 918-947-8854
Contact us at:
claims@fivestarassurance.com
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DISCLAIMERS
¹ We will Not reimburse for: tires with less than 3/32 tread depth; tires on vehicles other than passenger cars, trucks or vans; any tire covered by manufacturer’s warranty; manufacturer recall or replacement programs; spare tires; cost of balancing or alignment of tires; replacement due to wheel or rim defects or leaks; vandalism, theft, fire or factory defects; used tire replacements. Reimbursement is limited to $100.00 per occurrence with a maximum reimbursement of $400.00 or 4 occurrences within 60 months from date of purchase. ²Tow reimbursement is limited to $100.00 per occurrence with a maximum of 4 occurrences or $200.00 within 60 months from the date of vehicle purchase. ³Roadside assistance is limited to $100.00 per occurrence with a maximum of 4 occurrences or $400.00 within 60 months from the date of vehicle purchase. Benefits are non-transferrable, receipts and supporting documentation must be provided with reimbursement form. Reimbursement requests must be submitted within 30 days of occurrence. All work needs to be completed at purchasing dealer. All reimbursement requests are subject to review. Dealer may cancel or change benefits program at any time without prior notification.