Submit the completed Washington State Tort Claim form to the following fax number: 360-507-9251. Before filing a Tort Claim, please read these instructions the Tort Claim form and other appropriate forms in their entirety.Pursuant to Chapter 4.92 RCW, this form is for filing a tort claim against the state of Washington. Some of the information requested. This page has information to help you if you are suing someone in small claims court or being sued. Which one applies to you? We have no intent to want to run our medical providers out of business and out of this State. Demonstrate how billing gets processed to insurance carriers for reimbursement, including learning how to fill out billing forms. Please keep this Certificate as an explanation of the benefits available to the Insured Person under the contract between the Company and the Policyholder. Done at the city of Washington this.