Ovs Claim Application And Instructions printable pdf download

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,

for?

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.)

claim?

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?

needs?

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

Ovs Claim Application And Instructions

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