The Application for Benefits (AFB) is a standard form sent to you when a Personal Injury Protection (PIP) claim is presented.  Completing and returning the form ensures a claim is promptly and accurately addressed by our Claims Department.  And, because this form has many components, we want to be certain you were familiar with a few of the very important areas of information it contains.

Crucial to our reporting needs is completing the injured person’s complete legal name, date of birth, social security number, and injuries sustained.  This information is necessary not only for the AFB, but also for a number of additional reports, including to entities like Medicare.

Within these forms, you will also find opportunities to document any out of pockets expenses and wage losses.  It is important our adjusters are aware of these expenses so they can be considered for payment.

There is much more important information requested on the AFB, but these are a few often overlooked examples.  Having the necessary information returned helps the adjuster more efficiently process the claim.  If you or your insured has any questions when filling out the form, they may contact their handling adjuster, and he or she would be happy to assist them.