Dear AAA Plus or Premier Member,
Please read about your AAA Western and Central New York Road Trip Interruption Protection benefit below. The following
information includes eligibility and documentation required for reimbursement consideration. Trip Interruption Protection
begins 7 days after Plus or Premier enrollment or upgrade. Pre-existing breakdowns are not eligible for Trip Interruption
Protection. One claim allowed per incident. Delays due to extreme weather conditions are not reimbursable in the
absence of specific mechanical failure. Requests must be submitted within 5 months of the disablement or theft.
PLEASE CHECK THE APPLICABLE DOCUMENTS SUBMITTED WITH YOUR CLAIM.
o
Completed reimbursement form (page 2).
o
Copy of dated and itemized vehicle repair receipt from a certified garage.
o
Copies of dated and itemized receipts for meals and lodging. (Credit Card statements not acceptable) OR
o
Copy of dated and itemized closing car rental receipt (e.g. Car Rental Agreement).
o
Copy of police report/accident report, if applicable.
o
A statement from Insurance company stating the vehicle was a total loss, if applicable.
PLEASE SUBMIT ALL APPLICABLE ITEMS TO AAA WESTERN & CENTRAL NEW YORK AT THE FOLLOWING:
BY MAIL: AAA OR BY EMAIL: mbrshp_acct@nyaaa.com
Attn: Membership Accounting
PO Box 9006
Buffalo, NY 14231
n In the event an auto trip* is delayed overnight or canceled due to mechanical disablement, collision causing
mechanical disablement, or theft of your eligible vehicle, AAA Plus and AAA Premier provides reimbursement for food
and lodging or standard car rental.* At the member’s option, a rental car can be secured to continue the scheduled
trip or to return home or seek temporary lodging and food while waiting for the completion of repair (not both). All
coverages cease upon returning home.
*Definition of Auto Trip: Travel beyond 100 miles from permanent or alternate residence.
*AAA Plus
®
membership provides an annual allowance of up to $350.
*AAA Premier
®
membership provides an annual allowance of up to $1500.
n For all reimbursements, proof of vehicle disablement is required (i.e. vehicle repair bill). If vehicle theft or accident
occurs, a copy of the police or accident report is required.
n Food and Lodging: Coverage for food and lodging ceases when vehicle is repaired or upon arrival at your trip
destination. Members must provide dated, itemized receipts for reimbursement consideration. Miscellaneous expenses
such as, but not limited to, alcoholic beverages, telephone charges and movie rentals are not covered. Credit Card
receipts without the establishment’s itemization are not eligible for reimbursement. Food/Lodging must be in the same
vicinity as the breakdown. Once you continue on your trip, food and lodging reimbursement is no longer available.
The Club may deny reimbursement for services not provided by established facilities.
Note: Prebooked Hotel expenses are not covered.
n Car Rental: Coverage for car rental ceases upon returning home. The closing car rental agreement must be dated
and itemized. Miscellaneous expenses such as, but not limited to, insurance options, additional driver fees, roadside
assistance, tolls and fuel charges, are not covered. A one day rental expense, to retrieve the repaired vehicle, will
be considered.
AAA Western & Central New York’s Membership Accounting reviews your RTI Claim Form for reimbursement consideration
based on the description of incident and the completeness of dated/itemized receipts supplied. Please allow
approximately 4-6 weeks to process the claim.
If you have any questions, please call 1-800-836-2582 extension 8233.
AAA Plus
®
/RV & AAA Premier
®
/RV
Road Trip Interruption Protection
340-18 (Pg 1 of 2)
Membership Level:
o
AAA Plus
o
AAA Premier
Membership Number: 620 084 ______________________________ Expiration: _____ /_____ /_________
Plus/Premier/RV Member’s Name: _____________________________________________________________________________________
Member’s Permanent Address: ________________________________________________________________________________________
City: __________________________________ State: _____ Zip: ______________ Telephone Number: ( ______ ) ________________
Email Address (For Correspondence): _________________________________________________________________________________
NYS Driver License # (For Car Rental): __________ __________ __________ Number of people traveling in vehicle: _________
Location of Incident: _______________________________________________________ Date of Incident: _____ /_____ /_________
Trip Destination: _______________________________________________________ Time of Incident: _____ : _____
o
AM
o
PM
Did you continue on your trip? (Check One)
o
Yes
o
No Date Returned Home: _____ /_____ /_________
Date of Tow: _____ /_____ /________ Repair Started: _____ /_____ /________ Repair Completed: _____ /_____ /________
Vehicle Serviced: Year: ____________ Make: ________________________________ Model: __________________________________
Describe the incident in as much detail as possible: ___________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
PLEASE CHECK THE ITEM FOR WHICH YOU ARE REQUESTING REIMBURSEMENT:
o
Food And Lodging OR
o
Car Rental
Amount of reimbursement request: $____________________
I understand that reimbursement will be considered within specified limitations based on the dated itemized receipts
included and will not exceed $350 annually for AAA Plus members and $1,500 annually for AAA Premier members.
I also understand that one claim allowed per incident and AAA Western & Central New York or its affiliates reserve
the right to request any additional information from me which it considers necessary for use in considering my
request for reimbursement.
Plus/Premier/RV Member Signature: ___________________________________________________ Date: _____ /_____ /_________
AAA Plus
®
/RV & AAA Premier
®
/RV
Road Trip Interruption Claim Form
340-18 (Pg 2 of 2)
ACCOUNTING USE ONLY:
CLAIM RECEIVED: _____ /_____ /________ CLAIM #: _________________________ LTV: _________________ JOIN DATE: _____ /_____ /________
ISSUED BY: __________________ REVIEWED BY: __________________ TOTAL AMOUNT OF REIMBURSEMENT: $ __________________
DEPARTMENT APPROVAL: _______________________________________ PREMIER ACCOUNT #:
o
1.8264.407.00 AMT: $ __________________
PLUS ACCOUNT #:
o
1.8266.407.00 AMT: $ __________________
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