Get Claim Form - Connectorsettlements.com

This guide provides detailed instructions on how to complete the Claim Form related to Watts Water Heater and FloodSafe Connectors. Following these steps will help ensure that your submission is accurate and complete.

Follow the steps to complete your claim form effectively.

1. Press the ‘Get Form’ button to obtain the claim form and open it in the online editor.
2. Enter your claimant information by checking the applicable box to identify yourself as either a business or individual. Fill in your first name, middle initial, last name, and, if applicable, business name. Provide your Social Security number or Tax Identification number, current mailing address, phone numbers, and email.
3. Indicate your relationship to the property by checking the appropriate box (homeowner, tenant, insurer, owner of commercial property, or other) and specify if you are submitting the claim on behalf of another party. Confirm if this is the only claim you have ever made under this settlement.
4. Provide the description of the property where the Watts Water Heater and/or FloodSafe Connector is or was located by entering the property address in the designated fields.
5. Complete the section for insurers if you are making a subrogation claim. Include the insured's name, mailing address, and contact information.
6. Identify your Watts Water Heater and/or FloodSafe Connectors. Check how you determined your connectors' presence (inspection, packaging, etc.) and provide documentation proof for ownership.
7. In the replacement remedy section, indicate the number of Watts Water Heater connectors and FloodSafe Connectors you seek reimbursement for, including documentation such as receipts and photographs.
8. Fill out the property damage remedy section only if claiming for damage repairs. Provide details about the damage, amounts paid out-of-pocket, and any prior claims if applicable.
9. Complete the settlements section if you have engaged in any settlements related to your claims. Attach relevant documentation if applicable.
10. Include any additional information you feel is necessary in a separate document if needed.
11. Sign and date the form, certifying that all information is true to the best of your knowledge. Ensure all fields are completed before submission.
12. Save your changes, then download, print, or share the completed form and required supporting documents.

Start your claims process online by completing your Claim Form today!