Claim Submission Form

Submitting a Claim

If you believe that the Municipality has been negligent in its maintenance of municipal facilities, roads, trees and sewers, which has caused bodily injury or damage to your property, you can submit a claim to the Municipality.

You may wish to seek legal advice regarding your claim as there are important timelines to consider when making a claim against a Municipality.

If you have auto or property insurance, please consult your insurance company or broker first, for advice on how to deal with your loss. Your insurance coverage may be more extensive than what you can recover from the Municipality.

General Notes

Before submitting a claim, it is important to keep in mind the following:

• Making a claim against the Municipality is a legal process and will take time as an investigation will be conducted to determine if the Municipality was negligent, causing the damage or injury.
• Generally speaking, "negligence" involves the failure to meet the appropriate standard of care.
• The Municipality makes payment only where the Municipality is legally liable for the damage of injury caused. Determination of liability is based on the presence of negligence on behalf of the Municipality.
• For property damage claims, if the Municipality is found to be negligent, the amount that you would receive in compensation is limited to current value and not replacement value and the Municipality will not reimburse for improvements beyond the condition of the property just before the damage occured.
• The investigation of your claim must be completed before the Municipality will be in a position to consider any compensation with respect to repairs/costs. It is your decision if you choose to proceed with repairing damaged property prior to the outcome of your claim.
• The length of time to investigate will depend upon the complexity and severity of the claim as well as the volume of claims received at certain peak seasons.

Claims Involving Private Contractors

The Municipality of Leamington provides many services with its own staff. However, the Municipality also frequently enters into contracts with independent companies ("contractors") for the provision of services on the Municipality's behalf.

Should a claim be recieved by the Municipality whereby it is determined that a contractor had control over the accident location at the time of the loss/damage, the Municipality will notify you in writing that a contractor is responsible for your claim, and will provide the name and contact information of the contractor involved to you so that you may pursue your claim directly with the responsible contractor. Should the contractor deny a claim for damage, loss or injury, the Municipality cannot intervene directly on your behalf.

If Your Claim is Denied 

Notwithstanding the Municipality's efforts, you may disagree with the assessment of the extent of the Municipality's legal responsibility of your loss. In such cases, you are free to commence formal proceedings before the courts in an effort to obtain compensation. You should seek legal advice prior to commencing a claim.

Questions: Questions related to claims processing can be directed to Legal Services by calling 519-326-5761.

Claim Information

Claimant Information

Incident Information

Please provide a full description of the damage or injury that occurred. This claim will be processed by Legal Services and may be submitted to the Municipality's Insurance Adjuster You will be contacted within two business days to advise that your claim has been received.

Acknowledgement: By sending this form, I acknowledge that the information provided on this form is true and correct. I understand that any person(s) who, with intent to defraud or knowing that he/she/they is facilitating a fraud against an insurer, files a claim containing a false or deceptive statement, is guilty of insurance fraud.

Privacy Statement: The information collected on this form is collected under the authority of the Municipal Act, 2001, s.10. This information will be used solely for the purpose of processing the claim and may be supplied to the Municipality's insurance adjuster and/or those from whom the Municipality may claim contribution or indemnity. Questions about the collection of this information can be directed to the Manager of Legislative Services/Clerk, Municipality of Leamington, 111 Erie Street North, ON N8H 2Z9. 519-326-5761.