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How to file a claim?

What should I do when someone wants to file a Liability claim against my district?

The CAPRI Claims Manual provides detailed instructions on how to handle a Liability claim made against the district. Exhibit F in the claims manual should be provided to the claimant to assist them if filing a formal claim. Log into the Member Portal for additional resources and forms.  Please note that all claims received by the district should immediately be forwarded to:

Matthew Duarte
Executive Director
CAPRI
1075 Creekside Ridge Drive, Suite 240
Roseville, CA 95677
(916) 722-5550
Fax: (916) 722-5715
E-mail: mduarte@capri-jpa.org

 

How do I file a Workers’ Compensation claim?

Within 24 hours of an employee being injured on the job, the district must provide the employee with a DWC-1 notice, the district must complete the Employer portion of DWC-1, Form 5020, and the Supervisor’s Report of Injury. Log into the Member Portal for additional resources and forms. 

Email above forms to:

Sally Town
Workers’ Compensation Claims Examiner
Phone: 916.960.0969
E-mail: sally.town@sedgwick.com

 

What should I do if my district sustains a Property Loss?

The district must notify CAPRI within 72 hours following your discovery of the loss. The district must also complete the Property Loss Notice Form (Exhibit S in the CAPRI Claims manual) and forward it to the CAPRI office. If the loss was the result of a criminal act (theft, vandalism, arson, etc.) or vehicle accident, provide CAPRI with a copy of the police report. After the damage has been repaired, organize and forward the paid invoices to the CAPRI office for payment. Log into the Member Portal for additional resources and forms.