Keene Claim Form

Claimants may either file a paper copy claim form or electronically file the claim. Claimants must complete the standardized claim form in its entirety and sign the certification verifying the accuracy of the allegations or sign the Electronic Filer Agreement for electronic claim filing. Valid medical documentation supporting the alleged injury and documentation establishing exposure to Keene asbestos-containing products must be submitted with the claim. Additionally, the claim must be submitted within the applicable statutes of limitation period as set forth in the Keene Claims Resolution and Trust Distribution Procedures Section 5.1(d).