About your Sunglasses

You will need the purchase receipt for your covered sunglasses to complete this portion.

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Download sample receipt

Receipt number is required. The receipt number must have 7 digits.
Store number is required. Invalid store number.
The purchase date of your covered sunglasses is required. Your purchase date has exceeded the eligible timeframe to purchase the Sunglass Loss Protection Insurance Policy.
UPC of sunglasses is required. Please enter a valid UPC code. Brand is required.
Brand name is required. Enter a valid brand name.
Purchase price of your sunglasses is required.

About You

Tell us about yourself.

First name is required.
Last name is required.
Address is required. Invalid Address
Zip is required. Invalid zip.
City is required.
State is required.
Email is required. Invalid email address
Email confirmation is required Invalid email confirmation.
Primary phone is required. Invalid phone number.
Invalid phone number.

Billing Information

*Your card was declined.

Card holder name is required. Invalid card holder name.
Card number is required. Card number invalid. Invalid card number.
CVV is required. CVV is invalid. Invalid CVV for card type.
Expiration month is required. Invalid month.
Expiration year is required. Invalid year. Card is expired.
Billing address is required.
Billing zip is required. Invalid zip.
Billing city is required.
Billing state is required.
Billing phone is required. Invalid phone number.

Review Order

Please review your contact and billing information below to complete your purchase.

We are unable to process your payment at this time. Please try again later.

{{Customer.FirstName}} {{Customer.LastName}}

{{Customer.Address.Address1}}

{{Customer.Address.Address2}}

{{Customer.Address.City}}, {{Customer.Address.State}} {{Customer.Address.Zip}}

{{Customer.Email}}

{{Customer.Phone1}}

{{Customer.Phone2}}

{{Billing.CardType()}}

**** **** **** ****

{{Billing.Cvv}}

{{EffectiveBillingAddress().Address1}}

{{EffectiveBillingAddress().Address2}}

{{EffectiveBillingAddress().City}}, {{EffectiveBillingAddress().State}} {{EffectiveBillingAddress().Zip}}

Please carefully read and confirm the following before completing your purchase.

  • My policy term starts on the Policy Effective Date and ends on the Expiration Date listed on the Declarations page.
  • Administrator must review and approve claims.
  • Exclusions apply. See Policy for complete details.
  • Only one replacement claim is allowed within the policy coverage term.
  • There is a {{item.Deductible | currency}} deductible per covered claim for UPC {{item.Upc}}.
  • See the Sunglass Loss Protection Insurance Policy for cancellation and refund details.
  • I am the card holder or an authorized user of the debit card or credit card provided.
  • I hereby authorize and give consent for AMT Warranty Corp (AMT) or its payment vendor to charge my designated debit card or credit card today for the cost listed above.
  • I consent to receiving all Insurance Policy communications electronically from AMT or its subsidiary.
  • The coverage is not available for a replacement pair.
  • Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison.

I confirm that I have read and understand the above statements and agree to the Sunglass Loss Protection Insurance Policy. Click here to download/print a copy of the Policy.

By signing below, you agree that you have read this policy in its entirety, and consent to the terms, conditions, limitations and other provisions of this policy. You acknowledge that no other verbal representations have been made to you that differ from the provisions of this policy, and understand that enrolment in coverage is not required in order to purchase the covered eyewear.

Signature required. Signature must contain at least a first and last name.

By typing your name above, applicant hereby acknowledges and agrees to sign this application electronically (“e-Signature”). Applicant agrees that such e-Signature is the legal equivalent of providing a signature in writing on this application, and thereby provides consent to be legally bound by the provisions included herein. Applicant further agrees that no certification authority or other third party verification is necessary to validate their e-Signature, and that the lack of such certification or third party verification will not in any way affect the enforceability of their e-Signature or any resulting policy between the applicant and Technology Insurance Company, Inc. Applicant also represents that they are authorized to enter into this agreement.

Purchase Completed

Congratulations

You have successfully completed the purchase of your Sunglass Loss Protection Insurance Policy. A confirmation email will be sent to {{Customer.Email}} shortly.

Your Insurance Policy number is {{item.PolicyNumber}} for UPC {{item.Upc}}.
Order #: {{item.PolicyNumber}}
Order Date: {{TransactionDate}}
Order Detail: {{PlanDescription}}
Policy Term: {{Duration}}
Policy Premium: Total Amount - $5.98
Checkout Detailspair(s)
{{i.EffectiveBrand()}}
{{i.Deductible | currency}} Deductible|UPC: {{i.Upc}}
Purchase Price: {{i.PurchasePrice | currency}}
TOTAL DUE
{{(5.98 * Covered.Items.length) | currency}}