Master Claim Instructions
STEP 1 CREATE A MASTER CLAIM ITEMIZATION TABLE
- Download the Master Claim Itemization Table from our website by clicking here.
- If you are unable to download the form, you can create your own form in Microsoft Excel or Microsoft Access as long as it includes all of the headers below:
|a. Insurance Company Claim or Policy #
||f. Date Invoiced
|b. Invoice or Reference #
||g. Amount of Invoice
|c. Claimant/Insured Name
||h. Payments Applied
|d. Date Assignment Received (Required)
||i. Dates Payments Applied
|e. Date Completed (if applicable)
||j. Total Amount Claimed
- The Master Claim Itemization Table is provided as a Microsoft Excel Spreadsheet. If you do not have this program, you can download a free Microsoft Excel Viewer by clicking here.
- The total amount claimed on your Proof of Claim Form must equal the total amount claimed on your Claims Vendor Master Claim Itemization Table. Below is a sample of how a Master Claim Itemization Table should be completed:
- TIP: Your accounting software may be able to produce a report with the same information required on the Master Claim Itemization Table. As long as your report has the minimum detail shown in the table in Step #1 above, we will accept it as an itemization summary of your claim.
STEP 2 IMAGE INVOICES LISTED ON THE MASTER CLAIM ITEMIZATION TABLE
- Create a consolidated* image of all the invoices listed on the Master Claim Itemization Table. If possible, the images should match the invoices in the order that they are listed in the Master Claim Itemization Table.
“Consolidated” means a PDF (Adobe.pdf) of scrollable images.
For samples of the information needed on an invoice, please click here.
STEP 3 IMAGE SUPPORTING WORK PRODUCT/DELIVERABLES
- Image any work product/deliverable related to the invoices (e.g. estimate, summary report, signed appraisal award, etc.).
STEP 4 IMAGE CONTRACT AND/OR FEE SCHEDULE
- Create an image of the applicable contract and/or fee schedule between your organization and the company in receivership.
STEP 5 CREATE A CD (ONLY APPLIES IF YOU ARE MAILING YOUR SUBMISSION)
- If you are mailing your claim information to the Receiver, please copy (burn) the information above in steps 1, 2, 3 and 4 to a CD. Label the CD with 1) the name of your company (the claimant), 2) your RCN (this number is located on the Notice or the Proof of Claim Form you received) and 3) the name, phone number and e-mail of a contact person at your company who can answer questions regarding the master claim being submitted.
- Note: Claims submitted in a format other than what is specified may delay evaluation of your claim, result in the rejection of your claim in its entirety and/or require an offset against your claim for any administrative costs incurred.