Claim Packet

CRITICAL CLAIM DOCUMENTS:

This section contains all the documents and information necessary to complete the claim process. You may submit your claim electronically or by mail. These documents may be printed off the web site, or you may write to the Trust and we will send you the documents that you request.

User's Guide 
Training Seminar Slides

Claim Form

Claim Form (Word)

Claim Form (.pdf)

Claim Checklists
Checklist - Grade I Asbestosis
Checklist - Grade I Enhanced Asbestosis
Checklist - Grade II Asbestos Related Pleural Disease
Checklist - Grade I Serious Asbestosis
Checklist - Lung Cancer
Checklist - Mesothelioma
Checklist - Other Cancer

Trust Approved Interrogatories
California Claim Form Interrogatories — Personal Injury (PDF)
California Claim Form Interrogatories — Personal Injury (Word)
California Claim Form Interrogatories — Wrongful Death (PDF)
California Claim Form Interrogatories — Wrongful Death (Word)
Verification for Responses/Answers to Interrogatories

Litigation Declaration
Litigation Declaration — Claimant
Litigation Declaration — Attorney

Traditional Occupation List
High Exposure Jobtypes

Disclaimer
Pursuant to Section VII, subsection b, of the Case Valuation Matrix, the site/ship lists may be modified in light of additional evidence or experience with claims processing. However, if a claim is submitted with exposure at a site or on a ship which is subsequently removed from the approved list after the claim was submitted and before it is approved for payment, the claim's filing fee will be fully refunded.

Land Based Site List
J.T. Thorpe Site List 04/2015 (Excel)
J.T. Thorpe Site List 04/2015 (PDF)
J.T. Thorpe Site List-DELETED SITES 06/19/2008 (PDF)

Ship List
J.T. Thorpe Ship List 04/2015 (Excel)
J.T. Thorpe Ship List 04/2015 (PDF)

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