Download the benefits application for submission




A claims application must be filed either in person or by mail with the Minnesota Automobile 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.  Apparently eligible claims will be assigned to one of the Servicing Insurers.

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 directly from this website. The application is in Microsoft Word 6.0 format.

Download the Benefits Application   Download Benefits Application.
  21KB  < 1 min @ 28.8 Kbps

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.

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Last updated: Sunday, October 18, 2010
�2001 Minnesota Automobile Assigned Claims Bureau
Information regarding this website can be directed to the Webmaster

It is not the purpose of any statement in this website to interpret the application of benefits under the law in any individual case, and should not be considered legal advise.