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Submit a Residential Claim for [Event Name]

If you lost power for more than 48 consecutive hours starting on August 4, 2020, you can file a claim to be reimbursed for spoiled food or prescription medication.

Thank You for Submitting Your Claim

An investigator will review your claim and contact you with a disposition as soon as possible. Please allow us approximately 30 days to complete our investigation.

If you have any questions, please contact us.

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ALL FIELDS ARE REQUIRED, UNLESS OTHERWISE NOTED

Requirements for Food Spoilage Claims

Proof required for food losses of $235–$540. Examples of acceptable proof of loss include: cash register tapes, store or credit card receipts, canceled checks, or photographs of spoiled items.

Please itemize all losses.

Proof is not required for food losses under $235.

Requirements for Prescription Medication Loss Claims

Proof required for all prescription medication losses. Examples of acceptable proof of loss include pharmacy prescription labels or pharmacy receipts identifying the medicine.

We may request authorization to verify the loss of prescription medicine.

Reimbursement for prescription medicine is not included in the $540 maximum for food spoilage.

Please let us know when you lost power due to the Christmas Eve storm.

Please provide details about the item(s) you lost during the outage. Please fill at least one row. If you have more than 10 items, please create and attach your itemized list.

ITEM 1

Please provide proof of all perishable merchandise losses. Accepted file types: JPG, JPEG, PNG, GIF, PDF, DOC, DOCX, XLS, XLSX. File limit: 8MB. You can upload a maximum of 10 attachments. Individual attachments can be up to 4MB. Attachments cannot exceed 8MB in total.

Please allows us approximately 30 days from the date of this correspondence to complete our investigation and provide you with a determination.

Your electronic signature is the same as your handwritten signature and is certification of the truth and accuracy of the information submitted. Your signature confirms that all of the information provided on this form is true and accurate to the best of your knowledge and represents your actual losses.

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