Filing a Claim

2. The Town Manager's Office is ONLY responsible for the filing of your claim and has no further involvement once it is forwarded to the Town's Insurer, MIIA. 

   MIIA requires sufficient time to complete an investigation of your claim. Compensation is paid only if the Town of Longmeadow is found liable. Liability is based on whether the Town knew of the pothole before your accident and failed to fix it in a reasonable amount of time. A reasonable amount of time varies based on number of factors including the number of potholes, weather and availability of equipment, materials and personnel.

   To preserve your rights, if the Town does NOT pay your claim, you may pursue your matter in the appropriate state court within three (3) years from the date of the incident.

   HOW TO FILE A CLAIM

   Fill out the form below If you incurred damages or injuries caused by roadway and sidewalk defects or potholes within town limits and are seeking a reimbursement or were involved in a collision with a vehicle owned or leased by the town, please follow the procedure outlined below. Note: All claims for sidewalk, roadway or pothole incidents MUST be filed within thirty (30) days of the date of the incident.

   Please Note:

   • All claims for sidewalk, roadway or pothole incidents MUST be filed within thirty (30) days of the date of the incident per the Statute of Limitations Law -  MGL Chapter 84, Section 18. 
   • The Town is not responsible for claims due to snow or ice, -  MA General Law Chapter 84, Section 17
   • The maximum amount of damages recoverable from a defect in way claim from the Town is $5,000. -  MA General Law Chapter 84, Section 15
   • All claims involving Town-owned or leased vehicles or personal injuries MUST be filed within two (2) years of the date of the incident per the Statute of Limitations Law, -  MA General Law Chapter 258, Section 4
3. 
5. Contact Information
7. First Name
8. Last Name
10. Address
12. City
13. State
14. Zip
16. Phone Number
17. Email
19. Incident / Claim
22. Exact Location of Incident
24. Detailed explanation of damages or injuries suffered
26. Date of Incident
    Date of Incident
27. Town vehicle registration/plate number (if applicable)
29. Supporting documents to include with your claim
31. Itemized estimate of damages and/or reports
32. Upload supporting documents
34. Copy of Police Report if applicable
35. Upload supporting documents
37. Pictures (preferably color)
38. Upload supporting documents
40. Copy of medical bills for personal injuries
41. Upload supporting documents
43. If estimate of repairs is over $500, a second estimate may be required
44. Upload supporting documents
46. Please allow the Town up to 48 hours to acknowledge your claim. Once your claim has been forwarded to the Town's insurer, MIIA, a representative will contact you. Thank you. 
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48. 1. Receive an email copy of this form.
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