Emergency Services Claim Support

Forms and Information to File an EMS Claim

ESClaimFormPicHave you had an accident in a county vehicle, loss of property or personal injury?
Here are some things that need to be done to expedite the insurance process for you and your supervisor, captain or chief

CONTACT INFORMATION SHEET






Injured Volunteer/Fire/Rescue should contact Company Nurse Program at 1-888-770-0925

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Document Center

The Document Center provides easy access to public documents. Click on one of the categories below to see related documents or use the search function.

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Categories always sorted by seq (sub-categories sorted within each category)
Documents sorted by SEQ in Ascending Order within category

AUTO ACCIDENT (BOTH NEED TO BE PLACED IN THE VEHICLE)3 documents

  • AUTO INSURANCE CARDS
    document seq 0.00
  • ACCIDENT CARDS
    document seq 0.00
  • CLAIM FORM
    document seq 0.00
    (Attach copy of police report, within 24 hours)

CITIZEN INJURY CLAIM1 document

  • CLAIM FORM
    document seq 0.00
    (SOMEONE OTHER THAN EMPLOYEE WHO GETS HURT, within 24 hours)

PROPERTY EQUIPMENT CLAIM2 documents

  • PROVIDE INCIDENT REPORT
    document seq 0.00
  • OBTAIN TWO WRITTEN QUOTES TO REPLACE ITEM
    document seq 0.00
    (within 24 hours)