Initial Supplement Request Form

Estimator form for documenting hidden damage discovered during teardown and submitting the first supplement request for insurer approval.

Claim and Repair Order Details

• Repair Order Number
• Claim Number
• Insurer Name
• Vehicle VIN
  Optional if the repair order already links the vehicle. Avoid collecting more PII than needed.
• Vehicle Year / Make / Model

Teardown and Hidden Damage Findings

• Teardown Completed Date
• When was the damage discovered?
• Hidden Damage Summary
  Describe the additional damage found, using clear, observable details. Include affected components and why the damage was not visible on the original inspection.
• Primary Damage Category
• Safety or Drivability Impact

Supplement Line Items

• Supplement Line Items
• Parts Needed
• Labor Operations Needed
  List additional labor operations, such as R&I, structural repair, diagnostics, calibration, or refinish steps.
• Estimated Additional Labor Hours
• Estimated Additional Cost

Photo Evidence and Attachments

• Damage Photos
  Upload clear photos showing the hidden damage, teardown state, and any related components. Include wide shots and close-ups where helpful.
• Supporting Documents
  Optional estimate pages, scan reports, measurement sheets, or OEM procedures.
• Photo Notes
  Add brief captions or reference numbers that match the uploaded images.

Submission and Approval Details

• Urgency Level
• Insurer Contact Name
• Insurer Contact Email
• Ready to submit for insurer approval
  By checking this box, you confirm the supplement request reflects the current teardown findings and attached evidence.