ClaimInformation

Claim Information

Claim information is as follows. The required information is bold. You may choose to upload information for Litigation, or Exposure History or all of them at once. Please see the requirements for each section.

• AttorneyID

  • this is provided by CRMC

  • ContactID

  • this is provided by CRMC

• CopyDocs

  • Yes or No. Will copy all available medical documents that the claimant may already have on file to the newly created claim.

• First Diagnosis Date

  • Alleged first diagnosis date

  • Current State

  • Current State of residence (state codes)

• Current Country

  • Country if outside the US (country codes)

• Jurisdiction State

  • Claimant's jurisdiction election (state codes)

• Valuation Option

  • Only the ER option is available; For IR Claims you must use the IR template.

    • ER

      • expedited review

• Processing ElectionCD

  • Possible elections include:

    • ACC

      • Annual contribution claim (most claims would fall into this election)

      • PEU

        • Pre-established Unliquidated

• AsbLawsuitQuestion

  • Yes or No answer to the question “Has an asbestos-related lawsuit ever been filed on behalf of the injured party?”

  • If “Yes”, the claimant and the claimant’s law firm must attach to this Claim Form the Face Sheet of the complaint or full caption of the case to confirm the information and show the names of the plaintiff(s) and defendant(s), including the name of the injured party.

• AffirmPOCReview

  • Yes or No response to the following statement "I affirm I have reviewed and understood the Instructions for Completing the NARCO Asbestos Trust Proof of Claim Form for Unliquidated Claims to be Processed Under Expedited Review. I further certify that I am authorized by the Claimant to submit a claim, and that the information and materials with respect to this claim filed through the e-Claims system with the NARCO Trust, submitted now or in the future, including any supplemental documentation or information, changes, and corrections are and will be submitted pursuant to and subject to the provisions of Rule 11 of the Federal Rules of Civil Procedure and the Hybrid Filer Agreement. In addition, by submitting this claim through e-Claims, I certify and warrant that if the claim is filed on behalf of the injured party and/or the injured party's estate, the person filing the claim is authorized by law to file the claim on behalf of the injured party, the injured party's heirs, representatives, successors, assigns and estate.

  • Litigation Information

  • see about Litigation Information here

• HybAllegedDiseaseCD

  • more about AllegedDisease here

  • Exposure Information

  • see about Exposure Information here