EPI Claim Forms

IRC Claim

The IRC claim option is designed primarily for claimants suffering from serious or fatal asbestos related injuries resulting from exposure to EPI asbestos-containing products who seek an in-depth individualized review of the claim using basic tort system principles to determine the severity of the injury. Payment of valid IRC claims requires the execution of a full and final release and the selection of either the one-payment (70%) or two-payment plan. Claimants with less severe injuries may also file an IRC claim.

To file an IRC paper claim, please follow these steps:

  1. Complete the standardized EPI Trust claim form in its entirety and sign the certification of accuracy and completeness at the end of the form.
     
  2. Attach the required medical documentation supporting the alleged injury.
     
  3. Return the completed form and required documentation to the CPF.

Click here to download the EPI Claim Form.

To file an electronic IRC claim, click here.

Failure to complete the entire form and/or submit the required documentation will delay the processing of the claim. Claimants should describe the exposure history in as much detail as possible. Claims must be timely filed with the CPF within the applicable statute of limitations.

DCP Claim

The DCP claim option is designed primarily for claimants suffering from a less severe nonmalignant injury resulting from exposure to EPI asbestos-containing products who wish to have a fixed one-time payment now and retain the right to receive a further payment should the claimant be subsequently diagnosed with an asbestos-related malignancy. Claimants suffering from a malignancy may also file a DCP claim and receive a fixed one-time payment based on the payment schedule.

To file a DCP paper claim, please follow these steps:

  1. Complete the standardized EPI Trust claim form in its entirety and sign the certification of accuracy and completeness at the end of the form.
     
  2. Attach the required medical documentation supporting the alleged injury.
     
  3. Return the completed form and required documentation to the CPF.

Click here to download the EPI Claim Form.

To file an electronic DCP claim, click here.

Failure to complete the entire form and/or submit the required documentation will delay the processing of the claim. Claimants should describe the exposure history in as much detail as possible. Claims must be timely filed with the CPF within the applicable statute of limitations.