Get Professional Liability Claim Award Or Settlement - Kansas State ...

Filling out the Professional Liability Claim Award Or Settlement form for Kansas State can be a straightforward process when approached methodically. This guide will help you navigate through each section of the form, ensuring that your submission is complete and accurate.

Follow the steps to fill out the form correctly.

1. Click the ‘Get Form’ button to access the form and open it in your preferred document editor.
2. Begin by providing your personal information. Enter your full name and your license number in the specified fields to ensure proper identification.
3. Input the date of the occurrence. Make sure to use the exact date format requested on the form.
4. List the names of all claimants and defendants associated with the claim. This section is critical for identifying parties involved in the case.
5. If the incident took place in an institution, clearly state the name of that institution to provide context for the claim.
6. Enter the contact information for your attorney or the attorney representing your insurance provider. Include their name, address, and telephone number.
7. If a monetary settlement or award was made, detail the amount that was paid. If the case is ongoing, indicate that the matter is still pending.
8. Provide crucial case information. If a lawsuit was filed, input the case caption, court case number, and the court's name and location where the case is being handled.
9. Summarize the occurrence by outlining the circumstances, including a detailed description of the claimant’s alleged principal injury and any deviation from the accepted standard of care.
10. Review all provided information for accuracy. Once completed, you can save your changes, download the document, print it, or share it as needed.

Ensure your professional integrity is maintained by submitting your claim online today.