Ovs Claim Application And Instructions


New York State
Office of Victim Services
Claim Application and Instructions
How to Apply for Compensation
Who can apply for compensation?
Do I need a lawyer to file a claim to OVS?
Innocent victims of crime, certain relatives, dependents,
No. But, if you hire a lawyer to help you with this claim
legal guardians and eligible Good Samaritans can apply
and it is awarded, you can ask OVS to reimburse up to
to the Office of Victim Services (OVS) for compensation
$1,000 of the legal fees.
of out-of-pocket expenses not covered by insurance or
What if my property was lost, damaged or
other resources.
destroyed because of the crime?
What kinds of expenses can I get compensated
If you are under 18, 60 or over, disabled or were injured,
you may apply for benefits to replace your essential
OVS offers compensation related to personal injury,
personal property or cash that was not covered by any
death and loss of essential personal property.
other resource.
The specific expenses OVS may cover include:
Essential means necessary for your health and welfare,
like eyeglasses and clothes.
Medical, pharmacy and counseling expenses
Loss of Essential Personal Property (up to $500,
What if I move?
including $100 for cash)
Send OVS a signed letter right away. Tell us your new
Burial or Funeral Expenses (up to $6,000)
address and phone number. Also let us know if your
Lost Wages or Lost Support (up to $30,000)
email address changes.
(Parents or guardians of hospitalized minor children
What if I have questions or need help filing a
may be eligible for this benefit.)
Transportation (court/medical)
We can help you find a victim assistance program near
Occupational/Vocational Rehabilitation
you. Call us at: 1-800-247-8035
Security and Shelter
Or visit our website:
Crime scene clean-up (up to $2,500)
It’s best to fill out the form completely, or it may take
How do I ask for compensation?
longer to process your claim.
Send us your completed OVS application along with
copies of:
Who can sign the claim?
Police reports
Generally, the victim must sign the claim. However, if the
victim is under 18, or is physically or mentally incapable
Medical bills
of signing, then the legal guardian (the person receiving
Correspondence with insurance companies
the benefits) must fill out section 2 of the claim and sign
or benefits plan saying if they will cover your loss
the claim.
Insurance cards
If the victim died, the person asking for benefits must fill out
Receipts for essential personal property
section 2 of the claim and sign the claim.
Death certificate and funeral contract
Victim’s birth certificate
Do I have to fill out the attached
What if I don’t have some of the papers OVS
HIPAA form?
Yes. Fill out one HIPAA form for each service provider.
You can photocopy a blank form to make extra copies.
Send your application in right away. You can send the
other documents later.
80 S. Swan Street
55 Hanson Place
65 Court Street
Albany, NY 12210-8002
Brooklyn, NY 11217-1523
Buffalo, NY 14202-3406
(518) 457-8727
(718) 923-4325
(716) 847-7992
Rev. December 2013


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