Get Risk Management Damage Injury Claim Form - The City Of Nanaimo - Nanaimo

Filing a damage or injury claim with the City of Nanaimo is an important step in seeking resolution for any incidents that may have occurred. This guide will help you navigate the Risk Management Damage Injury Claim Form and ensure that all necessary information is accurately entered.

Follow the steps to complete your claim form effectively.

1. Press the ‘Get Form’ button to access the Risk Management Damage Injury Claim Form.
2. Begin by providing your personal information. Fill in your name, including your last and first name, followed by your residential address. Ensure that your home phone, work phone, and email are also included for contact purposes.
3. Indicate the date and time of the incident using the format DD/MMM/YYYY and specify the time of day.
4. Describe the location where the incident occurred. Be as detailed as possible to help pinpoint the site of the incident.
5. Provide a brief description of the damages or injuries sustained. If you require more space, additional details can be included in Schedule A.
6. Detail the amount of your claim in dollar amounts, and attach any supporting documentation or pictures that you may have related to the incident.
7. Identify who the damage or injury was first reported to and include the date when the report was made.
8. List the names of any city staff involved in the incident or describe any city facilities or equipment related to the claim.
9. Explain on what basis you believe the City should be responsible for the damages or injuries you incurred.
10. Confirm the accuracy of your statement by acknowledging the three statements regarding the correctness of the claim, timing of the incident, and insurance status.
11. Sign the form to validate your claim submission.
12. Return the completed claim form along with all supporting documents to the Legislative Services Department via mail, fax, or email as provided.
13. Once done, ensure to save changes to the form, and consider downloading, printing, or sharing the form as necessary.

Complete your Risk Management Damage Injury Claim Form online today to facilitate your claim process.