Alternate Claim Form

If the Injured Person in an Underlying Lawsuit is deceased and no estate is open, this Claim Submission Form may be submitted by the spouse or child, acting with written unanimous consent of all other living children. Alternate Claims are only eligible for Part A compensation. If the Injured Person in an Underlying Lawsuit is deceased and no estate is open, this Claim Submission Form may be submitted by the spouse or child, acting with written unanimous consent of all other living children. Alternate Claims are only eligible for Part A compensation.