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The Oregon Tort Claim form is an essential document for individuals seeking to file a claim against a state agency due to damages or injuries incurred as a result of the agency's actions or negligence. This form requires claimants to provide detailed information about themselves, including their name, contact information, and the specifics of the incident that led to the claim. Key aspects of the form include sections for describing the incident, the date and location where it occurred, and any witnesses involved. Additionally, claimants must indicate whether a police report was filed and provide the relevant details if applicable. The form also contains a bodily injury questionnaire, which collects vital information regarding any injuries sustained, medical treatments sought, and associated costs. It is important to note that the claim must be submitted within 180 days of the incident, as stipulated by Oregon law. For those filling out the form, assistance is available through the Risk Management office, which can be contacted via phone or email. Completing this form accurately and promptly is crucial for ensuring that claims are processed efficiently.

Common mistakes

  1. Incomplete Information: One common mistake is failing to fill out all required fields. Each section of the form is important for processing the claim. Omitting details, such as the date of the incident or the claimant's contact information, can lead to delays or rejection of the claim.

  2. Incorrect Submission Method: Some individuals do not use the specified software, like Acrobat Reader, to complete the form. Submitting the form in an incompatible format can result in loss of information or misinterpretation of the details provided.

  3. Missing Documentation: Another frequent error involves not attaching necessary supporting documents. For example, if there is a police report, it should be included. Providing photographs or estimates for property damage is also crucial, as these documents substantiate the claim.

  4. Ignoring the Deadline: Many claimants overlook the 180-day timeframe for submitting the claim. This deadline is critical, as failure to submit within this period can disqualify the claim, regardless of its validity.

Listed Questions and Answers

What is the Oregon Tort Claim Form?

The Oregon Tort Claim Form is a document used to file a claim against a state agency for damages or injuries that result from the agency's actions or negligence. This form is essential for individuals who believe they have suffered a loss due to the actions of a state employee or agency. Completing this form is the first step in seeking compensation for your damages.

How do I complete the Oregon Tort Claim Form?

Filling out the Oregon Tort Claim Form requires specific information. Here’s a quick guide:

  1. Provide your personal details, including your name, address, and contact information.
  2. Describe the incident, including the date, time, and location.
  3. Explain how the state agency is responsible for your damages or injuries.
  4. If applicable, include details about any witnesses and provide their contact information.
  5. For bodily injuries, complete the bodily injury questionnaire with accurate medical information.

Make sure to sign and date the form before submitting it.

What is the deadline for submitting the Tort Claim Form?

You must submit your claim within 180 days from the date of the incident. This timeframe is mandated by Oregon law (ORS 30.275). It’s crucial to keep this deadline in mind to ensure your claim is considered valid.

Where do I send the completed Tort Claim Form?

Your completed form should be sent to the Risk Management office. Here are the details:

  • Mailing Address: Risk Management | EGS, PO Box 12009, Salem, OR 97309-0009
  • Phone: 503-373-7475
  • Fax: 503-373-7337
  • Email: risk.management@oregon.gov

You can also find the form online at the State of Oregon Risk Management website.

What happens after I submit my Tort Claim Form?

Once your form is submitted, the Risk Management office will review your claim. They may reach out for additional information or clarification. After the review, you will receive a response regarding the status of your claim. This process can take some time, so be patient as they work through the details.

Form Specifications

Fact Name Details
Governing Law The Oregon Tort Claim form is governed by ORS 30.275.
Submission Deadline Claims must be submitted within 180 days from the date of the incident.
Contact Information Claims can be sent to Risk Management at PO Box 12009, Salem, OR 97309-0009. Phone: 503-373-7475.
Email Requirement All claims must be completed using Adobe Acrobat Reader and emailed to risk.management@oregon.gov.
Form Access The form is available online at the State of Oregon's Risk Management website.
Required Information Claimants must provide personal details, incident specifics, and any related injuries or damages.