sample claim forms

A person is called a claimant if he or she files a claim or an assertion over what he believes is true. The claim may be associated with reimbursements or a breach of the agreed contract between both parties.

A Claim Form is a legal document used for submitting a claim. The form should have supporting documents as proof, and it should be held by an attorney to face the court sessions. To prove the validity of the claim, the claimant may include a letter, a receipt, an original photograph, and all those physical entities that have to do with the other party.

Quit Claim Forms

Quit Claim Deed Form

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  • PDF

Size: 17 KB

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Generic Quit Claim Deed Form

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  • PDF

Size: 610 KB

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Real Estate Quit Claim Deed Form

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  • PDF

Size: 8 KB

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Expense Claim Forms

Free Expense Claim

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  • PDF

Size: 29 KB

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Expense Claim in PDF

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  • PDF

Size: 157 KB

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Placement Expense Form

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  • PDF

Size: 920 KB

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How to Fill Out a Medical Treatment/Reimbursement Claim Form

  • Start with the Claimant’s Information. This is where your personal and basic information will be stated. This includes your full legal name, birth date, and your contact details.
  • Name your patient. As a claimant, state whether the patient is a dependent of your membership.
  • Specify the Claim Details. The Claim Form will have a list of their medical services. You are required to choose from general wellness check-ups to medical treatments.
  • Dependent Declaration. This section is meant for the patient’s signature if he is a dependent of yours.
  • Plan the payment. Choose if you’d like a Reimbursement Form from your previous checkup payments or if you’d like the provider to pay for the expenses immediately.

Tips to Claim Your Travel Insurance Easily

Traveling through land, water, and air transportation require a passenger to be very careful with his valuables. A Travel Insurance Claim is the type of claim form that a passenger may submit to the airline authority whenever he is facing problems during and after the flight. Here are tips that you, as a passenger, should remember when you travel:

  • Keep photographs of the valuables you are bringing inside and outside your luggage bag. This is to serve as proof in case your things are stolen and found with another person.
  • Secure copies of your important documents like passports and government-issued papers as evidence of your identity.
  • Report to the local police department within 24 hours if you have been a victim of a criminal act.
  • File the claim immediately to inform the authority.

Medical Claim Forms

Health Insurance

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  • PDF

Size: 290 KB

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Medical Treatment

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  • PDF

Size: 520 KB

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Major Medical

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  • PDF

Size: 114 KB

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Travel Claim Forms

Travel Expense

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  • PDF

Size: 368 KB

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Travel Insurance

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  • PDF

Size: 27 KB

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Travel Reimbursement

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  • PDF

Size: 1 MB

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Travel Guard

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  • PDF

Size: 327 KB

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The Purposes of a Proof of Claim Form

A Proof of Claim Form is a single paged document that is to be completed with the information of both the creditor and debtor. The creditor is the one who usually files his statements in this form; however, in some instances that the creditor fails to act on his part for the agreement, the debtor is given a chance to be the claimant. The claim should indicate the intent of the claimant and the unpaid amount of the debtor to the creditor, or even the unfulfilled responsibilities of the creditor for the debtor. Reviewing the claim will be essential for both parties before proceeding to judicial hearings.

The Proof of Claim Form will likely vary on its structure, depending on its use. The Administrative Proof of Claim is for bankruptcy matters while an Accident Benefits Proof of Claim deals with an individual’s injury.

Things to Remember When Filing a Health Care Claim

Filing a Health Care Claim to the provider will be easier if you are fully aware of the necessary details that you should state. Listed below are the important things that you should keep in mind when you will begin filing your claim:

  • The healthcare provider’s expenses should be subjected to either you or to your dependents. You, as a claimant and not as a patient, cannot avail of the benefits of the claim if you did not include your household or the person who requires treatment as your beneficiary.
  • Always send your claims under your own health care plan first.
  • The primary carrier’s agreed statements should be included in the claim if you are married and you are coordinating a few expenses with your partner’s health plan.
  • The original receipts are required for your claim, so secure a copy of those documents before you submit it to the healthcare provider.
  • There are certain limitations for the minimum and maximum payments that the provider will shoulder. When you make your claim, make sure that the total expenses will reach the qualifications for the benefits.
  • Lastly, keep records of your claim forms.

Proof of Claim Forms

Proof of Claim in PDF

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  • PDF

Size: 74 KB

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Administrative Proof of Claim

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  • PDF

Size: 148 KB

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Accident Benefits Proof of Claim

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  • PDF

Size: 87 KB

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Health Care Claim Forms

Coventry Health Care

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  • PDF

Size: 47 KB

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Extended Health Care

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  • PDF

Size: 334 KB

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Health Care Expense

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  • PDF

Size: 42 KB

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Healthcare Reimbursement

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  • PDF

Size: 762 KB

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Basic Structure of a Claim Form

A Claim Form has specific areas that are marked as vital for every case even though each form varies according to its purpose and intent. We have listed below the general parts or the basic structures every Claim Form should include:

  • Introduction. This section refers to the information of the claimant, and the dependent, if there is a beneficiary involved. This will state the type of Claim Form, whether it is an Expense Claim Form or an Account Claim Form, and the claimant’s purpose for filing up the form.
  • Body. This is where the descriptions of the claim and the expenses are to be stated. The claimant should include the details of the accident if he is dealing with medical claim forms for accident benefits, and the doctor’s reports for those who are treating illnesses. The bills or payments and the total amount for the needed expenses should be tallied along with the receipts. The statement for the declaration of dependent will also be in this area of the form with the dependent’s name and signature.
  • Authorization for Releasing of Information. This entitles the claimant for the privacy of the information present in the form. He should affix his signature at the end of the agreement.

Disability Claim Forms

Disability Claim Application Form

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  • PDF

Size: 1 MB

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Annual Claim Form Disabled Student Allowance

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  • PDF

Size: 29 KB

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Disability Insurance

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  • PDF

Size: 460 KB

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Account Claim Forms

Spending Account Claim

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  • PDF

Size: 499 KB

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Health Spending Account

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  • PDF

Size: 259 KB

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Flexible Spending Account

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  • PDF

Size: 20 KB

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Electronic Claim Forms versus Manual Claim Forms

In this world filled with ever-evolving technology, the use of paper for forms is becoming less prevalent and taken over by online form usage. Even for government registrations and transactions, compressing the documents to send to the right authorities is easier if it is done through the cloud. Here are the lists of comparisons between electronic and manual forms:

  • Resources. When dealing with the use of resources, mainly ink and paper, there is no question that the electronic claim forms will surely save a number of sheets and folders to be used.
  • Evidence. This is the area where the advantage goes to manually made claim forms. Nothing is stronger than having physical evidence to present to the court. An electronic claim form can also be printed on paper, but technology cannot keep up against handwritten evidence.
  • Claimant’s Cost. Comparing the cost of an electronic claim form with a manual claim form may depend on the claimant. If the claimant already has the necessary resources to fill out an electronic form online, then there would be no cost issue. With ready-made government issued forms, all the claimant needs to do is go to the proper office, ask for a form, and manually fill it out.
  • Time-efficiency. The electronic claim form can be filled up and submitted in less than half an hour, which makes it convenient for busy individuals.
  • Storage. The cloud or the internet is a huge storage space for all needed documents for electronic forms, whereas, for the printed documents, a literal storage box will be needed, which is very space consuming.

Uses of Claim Forms

Claim Forms can be called all-around forms due to their many uses. A person may also use a Universal Claim Form to meet all his needs in stating a claim. Here are some areas where having the form will be a great advantage:

  • Real Estate. Dealing with real estate properties requires a set of documents; one of these is a Real Estate Quit Claim Deed Form, especially when filing disputes. The owners may file a case to the other party involved if there are misunderstood rights possessions. Although the presence of the owner is needed, what is more important is having supporting documents for the judicial case.
  • Expense. Money plays a huge role in any industry full of rules, regulations, and benefits. A claimant may file a form with his or her cooperating provider to access the benefits of the claim.
  • Medical and Health. The most common use of a claim is to have a healthcare provider support the finances associated with a dependent and the claimant who is in need of special medical treatments and services.
  • Travel. Traveling on air, land, and sea have their respective rights and benefits when dealing with claims. There are instances when a passenger’s luggage may be lost or stolen; therefore, the need to file a claim is always present.

Statement Claim Forms

Statement of Claim of Mineral Interest

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  • PDF

Size: 7 KB

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Statement of Claim for Local Court

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  • PDF

Size: 23 KB

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Statement of Claim for Victim in PDF

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  • PDF

Size: 32 KB

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Statement of Cross-Claim

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  • PDF

Size: 34 KB

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Claim Forms in PDF

Reimbursement Claim

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  • PDF

Size: 138 KB

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Member Claim

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  • PDF

Size: 67 KB

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Motor Claim

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  • PDF

Size: 140 KB

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Claim Forms in Doc

Mileage Claim

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  • DOC

Size: 22 KB

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Overcharge Claim

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  • DOC

Size: 7 KB

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Custom Claim

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  • DOC

Size: 73 KB

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52. Expense Claim Form

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  • XLS

Size: 701 KB

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Claim Forms can help the claimant pursue his claims. The most important aspect is showing enough proof and evidence to the court. When dealing with medical claims, it is highly recommended that the beneficiary’s name must be written under the claimant’s dependents to ensure that they will be carried out by the provider. The amount of the expenses to be shouldered by the provider may depend on the health plan of the claimant.

No matter what type of Claim Form you need, we have all sorts available on this site: from Quit Claim Deed Forms, Expense Claim Forms, Medical Claim Forms, Travel Claim Forms, Proof of Claim Forms to Account Claim Forms; you are given a variety of choices. All you have to do is know what the purpose of your claim will be and view our sample templates. When you have chosen the right form for yourself, click on the download button, and you are ready to go. Our forms can be downloaded in two formats: Word document and in PDF.

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