District of Columbia Claims (Adm)-Petition For Payment of Claim and Order (For Dates of Death From 07/01/95 To 08/26/01) is a form used to file a claim for payment for a death that occurred in the District of Columbia between July 1, 1995, and August 26, 2001. This form is used to request payment for death benefits, funeral expenses, burial costs and other related expenses that may have arisen due to the death. The form must be completed and submitted to the District of Columbia Department of Insurance and Securities Regulation. There are two types of District of Columbia Claims (Adm)-Petition For Payment of Claim and Order (For Dates of Death From 07/01/95 To 08/26/01): 1. Claim for Payment of Death Benefit — Used to claim payment for death benefits, funeral expenses, and burial costs. 2. Claim for Payment of Other Expenses — Used to claim payment for other expenses related to the death, such as medical bills, legal fees, and other costs.