To receive a payment, you must complete this Claim Form and submit it by December 31, 2020. If you have sustained Property Damage, you need to complete a separate Property Damage Claim Form. Both forms may be submitted online, or by e-mail, U.S. Mail or facsimile at the addresses listed at the bottom of this page.
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Please print the PDF versions of the Non-Property Damage Claim Form (and Attachment to Non-Property Damage Claim Form, if necessary), and submit the completed claim form(s) along with your supporting documents, if any, using one of the following methods:
Submit by e-mail:
CSR@flushmateclaims.com
Submit by mail:
Flushmate Claims Administrator
P.O. Box 1272
Lancaster, CA 93584
Submit by facsimile:
(661) 951-0978
If you have any questions, please call us toll-free at 1-877-412-5277 or visit our Contact Us page.