A claims application must be filed either by email, mail or fax with the Minnesota Automobile Assigned Claims Bureau. General assistance in completion of the form can be provided when necessary.
The Minnesota Automobile Assigned Claims Bureau will review each claim application form to eliminate those obviously ineligible. Possibly eligible claims will be assigned to one of the Servicing Insurers for investigation and processing.
The Servicing Insurers will handle all claims to conclusion. They will keep the Minnesota Automobile Assigned Claims Bureau advised of the progress and disposition of all claims.
Download the three-page benefits application using the button below directly from this website. The application is in Microsoft Word 6.0 format.
Click here for APPLICATION FOR BENEFITS
All compatible web browsers should display the document directly. If not, you can download this file and open the file within your word processing application of choice. If the document opens within your browser you can either:
1.) Fill out the form directly within your web browser and print it for submission or,
2.) Print the document and manually fill out the form.