Step 1: Creating a New Closed Claim Form (All Forms)

The New Closed Claims Wizard will guide you step-by-step through creating a new closed claim A demand for payment from a self-insured entity or an insurer for losses sustained by a claimant. form. After entering all data pertaining to a given claim you may review the data before submitting it to the Office of Insurance Regulation.  

To Start a New Closed Claim Filing

  1. Click the New Closed Claim link from the PLCR Workbench task bar.  The Start a New Closed Claim page will display.

  2. Click the Next button to continue.

 

 

  1. Select a Closed Claim Form (MPL, LPL, or DNO)

  2. Click the Next button.  

 

 

Select Insurer Type

  1. Select the type of insurer An entity licensed by OIR under Chapter 624 (p. III) or Chapter 641 (p. I) of the Florida Statutes. by clicking the radio button next to OIR Licensed Insurer or Self-Insured An individual or entity that has not purchased liability insurance. Entity.  

  2. Click the Next button to continue.

 

The Select Insurer Type Page

 

OIR Licensed Insurers

  1. If  you selected OIR Licensed Insurer the Select OIR Licensed Insurer page will display.  If you selected Self-Insured Entity, skip to step 7 under Self Insurers below.

 

The Select OIR Licensed Insurer Page

 

  1. To choose an insurer, click the radio button next to the insurer in the list of available licensed insurers. If you have no OIR licensed insurer in your Workbench, click the Add New Insurer button to add a new OIR licensed insurer to your Workbench.  Visit the Setting Up a Licensed Insurer help page for more information about adding a new licensed insurer.

  2. Click the Next button.  The Select Coverage Type page will display.  Proceed to step 10 below.

Self Insurers

  1. If  you selected Self Insured Entity the Self Insured Entity page will display.

 

The Select Self Insured Entity Page

 

  1. To choose a self insurer, click the radio button next to the insurer in the list of available self insurers. If you have no self insurer in your Workbench, click the Add New Self-Insured Entity button to add a new self insurer to your Workbench.  Visit the Setting Up a Self Insurer help page for more information about adding a new self insurer.

  2. Click the Next button.  The Select Claim Number and Name page will display.  Skip to step 12 below.

Coverage Type

  1. The Select Coverage Type page will allow you to submit claims for an insurer according to the amount of coverage. Select the type of coverage, either Primary or Excess.

    • Primary Coverage - An Insurer that insures up to the standard limit of coverage.

    • Excess Coverage - An insurer that has a limit of coverage above a primary insurer’s limit of coverage.

 

The Select Coverage Type Page

 

  1. Click the Next button.

Claim Number and Name

  1. Enter the claim number. If you are a self-insured entity, please create your own internal claim reference number or other identifying number.

  2. Assign a name to this claim for your own reference, if you wish.

 

The Enter Claim Number and Name Page

 

  1. Click the Save button. The Claim Summary page will display.  

 

You've now completed the initial steps for creating your new closed claim form. Please review Step 2 - Understanding the Claim Summary Page before proceeding to fill in your specific closed claim form.