A completed and signed Medical Records Release form (which can be printed above). A detailed explanation of the problem or situation.I freely accept and fully assume all risks, dangers and hazards and the possibility of personal injury, death, property damage and loss resulting therefrom. The release contained both an exculpatory clause and an indemnification clause. However, before signing a release it is important to know all your rights and all the potential legal implications of your claim. This FindLaw article discusses "release of all claims" forms, including what they are and what rights you're giving up if you sign one. This law requires payment within 30 days of receipt of a "clean" claim. Clean claims, and the information a carrier may request, are defined in COMAR 31.10.11. Access current claim information, filing forms and more. File a claim letter.