Get Insurance Claim Supplement Form

This guide provides clear and comprehensive instructions on filling out the Insurance Claim Supplement Form online. By following these steps, you can ensure that your submission is accurate and complete, facilitating the claims process.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the full name of the applicant in the designated field. Make sure to type clearly and accurately.
3. Next, provide the full name(s) of all person(s) involved in the claim. This ensures that all relevant parties are accounted for.
4. Enter the full name of the claimant in the corresponding section of the form.
5. Indicate whether you are reporting a claim/suit or an incident by selecting the appropriate option.
6. Fill in the date of the alleged error and the date of the claim using the format (mo/day/yr).
7. In the following fields, input the total loss paid, claimant’s settlement demand, and defendant’s offer for settlement, using numeric values where applicable.
8. Answer the question regarding whether the claim is in suit, and if yes, specify the amount asked in summons.
9. Provide a comprehensive description of the claim, detailing the alleged act, omission, and all relevant events. Include the type and extent of injury or damage sustained.
10. Describe the actions taken to prevent future incidents of a similar nature, showcasing your proactive approach.
11. Finally, review all entries for accuracy. Once satisfied, save your changes, and if needed, download, print, or share the completed form.

Complete your Insurance Claim Supplement Form online today for a smoother claims process.