AAA Claims Programs Services

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Self-Represented Arbitration </a> </li> <li class="we-mega-menu-li" data-level="1" data-element-type="we-mega-menu-li" description="" data-id="7121103b-d87a-4e41-bdbc-d473020f45b9" data-submenu="0" hide-sub-when-collapse="" data-group="0" data-class="" data-icon="" data-caption="" data-alignsub="" data-target="_self"> <a class="we-mega-menu-li" title="Statement of Ethical Principles" href="/StatementofEthicalPrinciples" target="_self"> Statement of Ethical Principles </a> </li> </ul> </div> <div class="we-mega-menu-col span6" data-element-type="we-mega-menu-col" data-width="6" data-block="headernavigationwhatwedo" data-blocktitle="0" data-hidewhencollapse="" data-class=""> <div class="type-of-block"><div class="block-inner"><section id="block-headernavigationwhatwedo" class="block block-block-content block-block-content62b1be62-55d1-45f5-bdb1-c47457d94433 clearfix"> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><h4><a href="https://go.adr.org/covid-19-virtual-hearings.html?utm_source=website&utm_medium=featurebox&utm_campaign=website_covid-19-virtual-hearing" id="" rel="" target="_blank" title="Virtual Hearings"><img alt="Virtual Hearings" data-entity-type="file" data-entity-uuid="c4e3360f-e971-4784-8d74-4f5d283d20f2" height="315" src="/sites/default/files/inline-images/virtual_hearings_450x375.png" width="315" loading="lazy" /></a></h4> </div> </section> </div></div> </div> </div> </div> </div> </li> <li class="we-mega-menu-li dropdown-menu" data-level="0" data-element-type="we-mega-menu-li" description="" data-id="970c5bf3-b9a1-46b8-9ad3-2316aabc69fc" data-submenu="1" hide-sub-when-collapse="" data-group="0" data-class="" data-icon="" data-caption="" data-alignsub="" data-target=""> <span data-drupal-link-system-path="<front>" class="we-megamenu-nolink">Practice Areas</span> <div class="we-mega-menu-submenu" data-element-type="we-mega-menu-submenu" data-submenu-width="" data-class="" style="width: px"> <div class="we-mega-menu-submenu-inner"> <div class="we-mega-menu-row" data-element-type="we-mega-menu-row" data-custom-row="1"> <div class="we-mega-menu-col span6" data-element-type="we-mega-menu-col" data-width="6" data-block="" data-blocktitle="0" data-hidewhencollapse="" data-class=""> <ul class="nav nav-tabs subul"> <li class="we-mega-menu-li" data-level="1" data-element-type="we-mega-menu-li" description="" data-id="8ae25089-1a23-49d2-8265-e6e40906a5c8" data-submenu="0" hide-sub-when-collapse="" data-group="0" data-class="" data-icon="" data-caption="" data-alignsub="" data-target="_self"> <a class="we-mega-menu-li" title="Commercial" href="/commercial" target="_self"> Commercial </a> </li> <li class="we-mega-menu-li" data-level="1" data-element-type="we-mega-menu-li" description="" data-id="c53ddcaa-693b-4f5a-8d07-9106a2fc8c80" data-submenu="0" hide-sub-when-collapse="" data-group="0" data-class="" data-icon="" data-caption="" data-alignsub="" data-target="_self"> <a 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span6" data-element-type="we-mega-menu-col" data-width="6" data-block="headernavigationpracticeareas" data-blocktitle="0" data-hidewhencollapse="" data-class=""> <div class="type-of-block"><div class="block-inner"><section id="block-headernavigationpracticeareas" class="block block-block-content block-block-content0d66761c-a3fe-4622-9f76-0a4dacbb7056 clearfix"> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p><a aria-label="" href="/Support" id="" rel="" target="" title=""><img alt="File AAA-ICDR Cases Online" data-entity-type="file" data-entity-uuid="ffb5d394-bbb9-44c7-979b-3d44e4546a89" height="226" src="/sites/default/files/inline-images/File-a-Case-Online.png" width="271" loading="lazy" /></a></p> </div> </section> </div></div> </div> </div> </div> </div> </li> <li class="we-mega-menu-li dropdown-menu" data-level="0" data-element-type="we-mega-menu-li" description="" data-id="090d16da-a811-423f-b94f-530346d49080" data-submenu="1" hide-sub-when-collapse="" data-group="0" data-class="" data-icon="" data-caption="" data-alignsub="" data-target=""> <span data-drupal-link-system-path="<front>" class="we-megamenu-nolink">InnovAAAtion</span> <div class="we-mega-menu-submenu" data-element-type="we-mega-menu-submenu" data-submenu-width="" data-class="" style="width: px"> <div class="we-mega-menu-submenu-inner"> <div class="we-mega-menu-row" data-element-type="we-mega-menu-row" data-custom-row="1"> <div class="we-mega-menu-col span6" data-element-type="we-mega-menu-col" data-width="6" data-block="" data-blocktitle="0" data-hidewhencollapse="" data-class=""> <ul class="nav nav-tabs subul"> <li class="we-mega-menu-li" data-level="1" data-element-type="we-mega-menu-li" description="" data-id="89b780d1-5a24-4c9a-9220-36382df5a648" data-submenu="0" hide-sub-when-collapse="" data-group="0" data-class="" data-icon="" data-caption="" data-alignsub="" data-target="_self"> <a class="we-mega-menu-li" title="InnovAAAtion" href="https://go.adr.org/innovation.html" target="_self"> InnovAAAtion </a> </li> <li class="we-mega-menu-li" data-level="1" data-element-type="we-mega-menu-li" description="" data-id="875d897c-fa6b-42af-8c27-4cbae3247f30" data-submenu="0" hide-sub-when-collapse="" data-group="0" data-class="" data-icon="" data-caption="" data-alignsub="" data-target="_self"> <a class="we-mega-menu-li" title="AAAiLab" href="https://aaailab.org" target="_self"> AAAiLab </a> </li> <li class="we-mega-menu-li" data-level="1" data-element-type="we-mega-menu-li" description="" data-id="abe070c2-e55a-45f4-87dc-346856a72eaa" data-submenu="0" hide-sub-when-collapse="" data-group="0" data-class="" data-icon="" data-caption="" data-alignsub="" data-target="_self"> <a class="we-mega-menu-li" title="CaseShield by AAA-ICDR" href="https://go.adr.org/Case-Shield" target="_self"> CaseShield by AAA-ICDR </a> </li> <li class="we-mega-menu-li" data-level="1" data-element-type="we-mega-menu-li" description="" data-id="5a63c7bb-4c2d-4329-a448-f047b6981541" data-submenu="0" hide-sub-when-collapse="" data-group="0" data-class="" data-icon="" data-caption="" data-alignsub="" data-target="_self"> <a class="we-mega-menu-li" title="ClauseBuilder AI Beta" href="https://clausebuilder.ai/" target="_self"> ClauseBuilder AI Beta </a> </li> </ul> </div> <div class="we-mega-menu-col span6" data-element-type="we-mega-menu-col" data-width="6" data-block="headernavigationinnovaaation" data-blocktitle="0" data-hidewhencollapse="" data-class=""> <div class="type-of-block"><div class="block-inner"><section id="block-headernavigationinnovaaation" class="block block-block-content block-block-content78ffed92-bbcf-4c14-9908-2b7f91a2ec8d clearfix"> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p><a aria-label="" href="https://go.adr.org/aaai-podcasts.html" id="" rel="" target="" title=""><img alt="AAAi Podcast" data-entity-type="file" data-entity-uuid="e30b78b1-8e13-494d-9d16-7599f79213e3" height="135" src="/sites/default/files/inline-images/AAAi_Podcast_Innovation_Dropdown.png" width="202" loading="lazy" /></a></p> </div> </section> </div></div> </div> </div> </div> </div> </li> <li class="we-mega-menu-li" data-level="0" data-element-type="we-mega-menu-li" description="" data-id="376045cd-e7fb-4753-98fe-4aca3c3f9407" data-submenu="0" hide-sub-when-collapse="" data-group="0" data-class="" data-icon="" data-caption="" data-alignsub="" data-target=""> <a class="we-mega-menu-li" title="Rules, Forms & Fees" href="/Rules" target=""> Rules, Forms & Fees </a> </li> <li class="we-mega-menu-li" data-level="0" data-element-type="we-mega-menu-li" description="" data-id="6fabf8fe-d3c4-4198-8914-61414ca42581" data-submenu="0" hide-sub-when-collapse="" data-group="0" data-class="" data-icon="" data-caption="" data-alignsub="" data-target=""> <a class="we-mega-menu-li" title="Clauses" href="/Clauses" target=""> Clauses </a> </li> <li class="we-mega-menu-li dropdown-menu" data-level="0" data-element-type="we-mega-menu-li" description="" data-id="f00f1b72-4c55-44f0-8e86-d8265999ea47" data-submenu="1" hide-sub-when-collapse="" data-group="0" data-class="" data-icon="" data-caption="" data-alignsub="" data-target=""> <span data-drupal-link-system-path="<front>" class="we-megamenu-nolink">Education, Resources & Publications</span> <div class="we-mega-menu-submenu" data-element-type="we-mega-menu-submenu" data-submenu-width="" data-class="" style="width: px"> <div class="we-mega-menu-submenu-inner"> <div class="we-mega-menu-row" data-element-type="we-mega-menu-row" data-custom-row="1"> <div class="we-mega-menu-col span6" data-element-type="we-mega-menu-col" data-width="6" data-block="" data-blocktitle="0" data-hidewhencollapse="" data-class=""> <ul class="nav nav-tabs subul"> <li class="we-mega-menu-li" data-level="1" data-element-type="we-mega-menu-li" description="" data-id="89712c0d-3278-417b-a310-aff3064896d9" data-submenu="0" hide-sub-when-collapse="" data-group="0" data-class="" data-icon="" data-caption="" data-alignsub="" data-target="_self"> <a class="we-mega-menu-li" title="AAA-ICDR Blog" href="/blog/home" target="_self"> AAA-ICDR Blog </a> </li> <li class="we-mega-menu-li" data-level="1" data-element-type="we-mega-menu-li" description="" data-id="c3a501a7-8264-4988-b443-c097e373852a" data-submenu="0" hide-sub-when-collapse="" data-group="0" data-class="" data-icon="" data-caption="" data-alignsub="" data-target="_self"> <a class="we-mega-menu-li" title="AAA Education Courses" href="https://www.aaaeducation.org/student/catalog" target="_self"> AAA Education Courses </a> </li> <li class="we-mega-menu-li" data-level="1" data-element-type="we-mega-menu-li" description="" data-id="07324d01-9c91-47c7-91a6-4a88b6c1ff05" data-submenu="0" hide-sub-when-collapse="" data-group="0" data-class="" data-icon="" data-caption="" data-alignsub="" data-target="_self"> <a class="we-mega-menu-li" title="AAA-ICDR Institute" href="https://go.adr.org/aaaicdrinstitute.html" target="_self"> AAA-ICDR Institute </a> </li> <li class="we-mega-menu-li" data-level="1" data-element-type="we-mega-menu-li" description="" data-id="33036ccc-1557-49dd-bab3-e9786187cf03" data-submenu="0" hide-sub-when-collapse="" data-group="0" data-class="" data-icon="" data-caption="" data-alignsub="" data-target=""> <a class="we-mega-menu-li" title="AAA-ICDR Resources" href="/adr-resources" target=""> AAA-ICDR Resources </a> </li> <li class="we-mega-menu-li" data-level="1" data-element-type="we-mega-menu-li" description="" data-id="d9e2a01c-ea6c-4a9a-a64f-a8cdd78ce3b9" data-submenu="0" hide-sub-when-collapse="" data-group="0" data-class="" data-icon="" data-caption="" data-alignsub="" data-target=""> <a class="we-mega-menu-li" title="Publications" href="https://www.adr.org/publications" target=""> Publications </a> </li> </ul> </div> <div class="we-mega-menu-col span6" data-element-type="we-mega-menu-col" data-width="6" data-block="headernavigationeducationresources" data-blocktitle="0" data-hidewhencollapse="" data-class=""> <div class="type-of-block"><div class="block-inner"><section id="block-headernavigationeducationresources" class="block block-block-content block-block-content319540ec-6953-487b-b058-a339f53c0b57 clearfix"> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p><a href="https://www.aaaeducation.org/student/catalog"><img alt="" height="144" src="/sites/default/files/document_repository/Education&Resources_600x400.jpg" style="float:left" width="216" /></a></p> </div> </section> </div></div> </div> </div> </div> </div> </li> <li class="we-mega-menu-li dropdown-menu" data-level="0" data-element-type="we-mega-menu-li" description="" data-id="7cb970a6-d35d-42e1-ad02-e81a9c38ee02" data-submenu="1" hide-sub-when-collapse="" data-group="0" data-class="" data-icon="" data-caption="" data-alignsub="" data-target=""> <span data-drupal-link-system-path="<front>" class="we-megamenu-nolink">Panel</span> <div class="we-mega-menu-submenu" data-element-type="we-mega-menu-submenu" data-submenu-width="" data-class="" style="width: px"> <div class="we-mega-menu-submenu-inner"> <div class="we-mega-menu-row" data-element-type="we-mega-menu-row" data-custom-row="1"> <div class="we-mega-menu-col span6" data-element-type="we-mega-menu-col" data-width="6" data-block="" data-blocktitle="0" data-hidewhencollapse="" data-class=""> <ul class="nav nav-tabs subul"> <li class="we-mega-menu-li" data-level="1" data-element-type="we-mega-menu-li" description="" data-id="73173cb5-0581-4d45-8d92-31e0881a9276" data-submenu="0" hide-sub-when-collapse="" data-group="0" data-class="" data-icon="" data-caption="" data-alignsub="" data-target=""> <a class="we-mega-menu-li" title="About the AAA Panels" href="/aaa-panel" target=""> About the AAA Panels </a> </li> <li class="we-mega-menu-li" data-level="1" data-element-type="we-mega-menu-li" description="" data-id="7570f3a9-b3d5-47bf-a450-b5b12f14b466" data-submenu="0" hide-sub-when-collapse="" data-group="0" data-class="" data-icon="" data-caption="" data-alignsub="" data-target="_self"> <a class="we-mega-menu-li" title="Arbitrator Selection" href="/ArbitratorSelection" target="_self"> Arbitrator Selection </a> </li> <li class="we-mega-menu-li" data-level="1" data-element-type="we-mega-menu-li" description="" data-id="352aaa29-8692-4e35-8a7a-8beb06754f9c" data-submenu="0" hide-sub-when-collapse="" data-group="0" data-class="" data-icon="" data-caption="" data-alignsub="" data-target="_self"> <a class="we-mega-menu-li" title="Find a Mediator" href="/FindMediator" target="_self"> Find a Mediator </a> </li> <li class="we-mega-menu-li" data-level="1" data-element-type="we-mega-menu-li" description="" data-id="653f950e-75e7-4e24-9a5d-b0e469a668ab" data-submenu="0" hide-sub-when-collapse="" data-group="0" data-class="" data-icon="" data-caption="" data-alignsub="" data-target="_blank"> <a class="we-mega-menu-li" title="Panelists: Sign in to Panelist eCenter" href="https://apps.adr.org/AAAApp/sso?action=login" target="_blank"> Panelists: Sign in to Panelist eCenter </a> </li> <li class="we-mega-menu-li" data-level="1" data-element-type="we-mega-menu-li" description="" data-id="56a558a6-74f0-4822-97e2-cc30387a5fdd" data-submenu="0" hide-sub-when-collapse="" data-group="0" data-class="" data-icon="" data-caption="" data-alignsub="" data-target="_self"> <a class="we-mega-menu-li" title="Roster Diversity & Inclusion" href="/RosterDiversity" target="_self"> Roster Diversity & Inclusion </a> </li> <li class="we-mega-menu-li" data-level="1" data-element-type="we-mega-menu-li" description="" data-id="648710a2-d0ad-4679-81f6-7bd6b7caaf8e" data-submenu="0" hide-sub-when-collapse="" data-group="0" data-class="" data-icon="" data-caption="" data-alignsub="" data-target="_self"> <a class="we-mega-menu-li" title="AAA-ICDR Women Panelist Resource Group" href="https://go.adr.org/AAA-ICDR-Women-Panelist-Resource-Group.html" target="_self"> AAA-ICDR Women Panelist Resource Group </a> </li> </ul> </div> <div class="we-mega-menu-col span6" data-element-type="we-mega-menu-col" data-width="6" data-block="headernavigationarbitratormediators" data-blocktitle="0" data-hidewhencollapse="" data-class=""> <div class="type-of-block"><div class="block-inner"><section id="block-headernavigationarbitratormediators" class="block block-block-content block-block-content0d23fe48-994d-4082-90b4-ad79d5f74303 clearfix"> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p><a aria-label="" href="https://go.adr.org/AAA-ICDR-Women-Panelist-Resource-Group.html" id="" rel="" target="" title=""><img alt="AAA-ICDR Women Panelist Resource Group" height="226" src="/sites/default/files/document_repository/Women_Resource_Group_NavImage.png" width="339" /></a></p> </div> </section> </div></div> </div> </div> </div> </div> </li> </ul> </div> </nav> </div> </section> </div> </div> </div> </header> </div> <div class="black_main_cont" role="navigation" aria-label="main container"> <banner class="header_banner block container"> <div class="region region-header-banner"> <section class="views-element-container page-title-sub-title-order-class block block-views block-views-blockpage-title-sub-title-block-1 clearfix" id="block-adrorg-views-block-page-title-sub-title-block-1"> <div class="form-group"><div class="view view-page-title-sub-title view-id-page_title_sub_title view-display-id-block_1 js-view-dom-id-17515beeff8bf010f5abac941386454e9b0d0faa4be987d602f6f1fd1cebb429"> <div class="view-content"> <div class="views-row"><div class="views-field views-field-rendered-entity"><span class="field-content"><h1> What We Do </h1><h2> </h2></span></div></div> </div> </div> </div> </section> </div> </banner> </div> <div role="main"> <div class="main-container container js-quickedit-main-content"> <div class="row secondaryTitle"> <div class="col-sm-12"> <div class="region region-page-title-bar"> <h3 class="page-header"> <span>Claims Programs</span> </h3> </div> </div> <section class="col-sm-8 bodyLeftContent"> <a id="main-content"></a> <div class="region region-content"> <div data-drupal-messages-fallback class="hidden"></div> <article data-history-node-id="3898" role="article" about="/ClaimsPrograms" class="what-we-do full clearfix"> <div class="content"> <div class="field field--name-field-wwd-image-text field--type-entity-reference-revisions field--label-hidden field--item"> <div class="paragraph paragraph--type--pa-img-richtexteditor paragraph--view-mode--default"> </div> </div> <div class="field field--name-field-wwd-description field--type-text-long field--label-hidden field--item"><p>AAA claims-resolution programs can be turnkey or customized for businesses and organizations in the public or private sector for high- or low-volume claims caseloads.</p> <p>AAA claims programs include many types of scalable, cost-effective programs, including <a href="/DisasterReliefPrograms" target="_blank"><strong><span style="color:#FF0000"><u>Disaster Relief</u></span></strong></a><span style="color:#000000">;</span><strong><span style="color:#000000"> </span><a href="/Employment" target="_blank"><span style="color:#FF0000"><u>Employment Dispute Resolution</u></span></a></strong><span style="color:#000000">;</span><strong><span style="color:#000000"> </span><a href="/Government" target="_blank"><span style="color:#FF0000"><u>National and Regional Insurance</u></span></a></strong>;<strong> </strong><a href="/sites/default/files/document_repository/AAA-Model-Mortgage-Mediation-Procedures_0.pdf" target="_blank"><span style="color:#FF0000"><strong><u>Residential Mortgage Foreclosure</u></strong></span></a>;<strong> <a href="/sites/default/files/document_repository/AAA-Municipal-Bankruptcy.pdf" target="_blank"><span style="color:#FF0000"><u>Municipal Bankruptcy</u></span></a></strong>; and <a href="/Government" target="_blank"><strong><span style="color:#FF0000"><u>Olympics and Sports Doping</u></span></strong></a>.<br /><br /> See <a href="/sites/default/files/document_repository/AAA191_Claims_Programs_Services.pdf" target="_blank"><span style="color:#FF0000"><strong><u>AAA</u></strong></span></a><span style="color:#FF0000"><strong><sup>®</sup></strong></span><a href="/sites/default/files/document_repository/AAA191_Claims_Programs_Services.pdf" target="_blank"><span style="color:#FF0000"><strong><u> Claims Programs Services</u></strong></span></a> for more information.</p> </div> <div class="field field--name-field-wwd-image-title-text field--type-entity-reference-revisions field--label-hidden field--items"> <div class="field--item"> <div class="paragraph paragraph--type--pa-img-text-richtexteditor paragraph--view-mode--default"> <div class="field field--name-field-pa-text-1 field--type-string field--label-hidden field--item">Corporate Bankruptcy Solutions</div> <div class="field field--name-field-pa-richtexteditor-3 field--type-text-long field--label-hidden field--item"><p>AAA claims-resolution programs are customized for reorganizing companies in varying industries. The type of claims resolved run the gamut from product liability to repayment of refunds due to termination of employment, and the processes utilized cover the spectrum from mediation to non-binding and standard binding arbitration.</p> <p>By legislation in 2010, Congress directed the AAA to develop and implement the high-profile <em>Special Binding Arbitration Program for Automobile Dealerships and Manufacturers, resulting in </em><a href="/sites/default/files/document_repository/A-Report-to-Congress-The-AAA-Auto-Industry-Arbitration.pdf" target="_blank"><strong><span style="color:#FF0000"><u>A Report to Congress: The AAA Auto Industry Arbitration</u></span></strong></a><span style="color:#000000">.</span></p> </div> </div> </div> <div class="field--item"> <div class="paragraph paragraph--type--pa-img-text-richtexteditor paragraph--view-mode--default"> <div class="field field--name-field-pa-text-1 field--type-string field--label-hidden field--item">Asbestos Personal Injury Trust Administration</div> <div class="field field--name-field-pa-richtexteditor-3 field--type-text-long field--label-hidden field--item"><p>U.S. Bankruptcy courts have allowed manufacturers of asbestos products facing substantial asbestos-related liabilities to file for bankruptcy and set up personal injury (PI) trust funds to compensate claimants. To date, the AAA has been named “private adjudication ADR administrator” by seven PI trusts and continues to add new ones.</p> </div> </div> </div> </div> </div> </article> </div> </section> <aside class="col-md-4 col-sm-4 contactUsRight" role="complementary"> <div class="region region-sidebar-second"> <section class="views-element-container block block-views block-views-blockcontact-us-webform-block-1 clearfix" id="block-adrorg-views-block-contact-us-webform-block-1"> <div class="form-group"><div class="view view-contact-us-webform view-id-contact_us_webform view-display-id-block_1 js-view-dom-id-0b29428f71ee74df10c33d95c73b574807cd512c4056123a52e9df8df4e5ef85"> <div class="view-content"> <div class="panel-group" id="views-bootstrap-contact-us-webform-block-1" role="tablist" aria-multiselectable="true"> <div class="panel panel-default"> <div class="panel-heading" class="panel-group panel-heading" id="headingviews-bootstrap-contact-us-webform-block-1-collapse-0" role="tab" aria-multiselectable="true"> <h4 class="panel-title"> <a class="accordion-toggle collapsed" role="button" data-toggle="collapse" data-parent="#views-bootstrap-contact-us-webform-block-1" aria-expanded="" aria-controls="views-bootstrap-contact-us-webform-block-1-collapse-0" href="#views-bootstrap-contact-us-webform-block-1-collapse-0"> Contact Us </a> </h4> </div> <div id="views-bootstrap-contact-us-webform-block-1-collapse-0" class="panel-collapse collapse " role="tabpanel" aria-labelledby="headingviews-bootstrap-contact-us-webform-block-1-collapse-0"> <div class="panel-body"> <div class="views-field views-field-nothing"><span class="field-content"><p>If you have questions about filing a new case, or if you have a general inquiry, contact Customer Service at <br /> 800-778-7879.</p> <p>For faster service, please complete the form below or send an email to <a href="mailto:CustomerService@adr.org">CustomerService@adr.org.</a> </p><br /></span></div><div class="views-field views-field-webform"><div class="field-content"><span id="webform-submission-contact-node-1-form-ajax-content"></span><div id="webform-submission-contact-node-1-form-ajax" class="webform-ajax-form-wrapper" data-effect="fade" data-progress-type="throbber"><form class="webform-submission-form webform-submission-add-form webform-submission-contact-form webform-submission-contact-add-form webform-submission-contact-node-1-form webform-submission-contact-node-1-add-form js-webform-details-toggle webform-details-toggle" data-drupal-selector="webform-submission-contact-node-1-add-form" action="/ClaimsPrograms" method="post" id="webform-submission-contact-node-1-add-form" accept-charset="UTF-8"> <div class="form-item js-form-item form-type-textfield js-form-type-textfield form-item-name js-form-item-name form-group"> <label for="edit-name" class="control-label js-form-required form-required">First Name</label> <input data-counter-type="character" data-counter-maximum="25" data-counter-maximum-message=" " class="js-webform-counter webform-counter form-text required form-control" pattern="^[a-zA-Z0-9]*$" data-webform-pattern-error="Special characters are not allowed for First Name." data-drupal-selector="edit-name" data-msg-maxlength="First Name field has a maximum length of 25." data-msg-required="First Name field is required." data-msg-pattern="Special characters are not allowed for First Name." type="text" id="edit-name" name="name" value="" size="60" maxlength="25" required="required" aria-required="true" /> </div> <div class="form-item js-form-item form-type-textfield js-form-type-textfield form-item-last-name js-form-item-last-name form-group"> <label for="edit-last-name" class="control-label js-form-required form-required">Last Name</label> <input data-counter-type="character" data-counter-maximum="25" data-counter-maximum-message=" " class="js-webform-counter webform-counter form-text required form-control" pattern="^[a-zA-Z0-9]*$" data-webform-pattern-error="Special characters are not allowed for Last Name." data-drupal-selector="edit-last-name" data-msg-maxlength="Last Name field has a maximum length of 25." data-msg-required="Last Name field is required." data-msg-pattern="Special characters are not allowed for Last Name." type="text" id="edit-last-name" name="last_name" value="" size="60" maxlength="25" required="required" aria-required="true" /> </div> <div class="form-item js-form-item form-type-email js-form-type-email form-item-email js-form-item-email form-group"> <label for="edit-email" class="control-label js-form-required form-required">E-mail Address</label> <input pattern="[a-zA-Z0-9._%+-]+@[a-zA-Z0-9.-]+\.[a-zA-Z0-9]{2,}" data-webform-pattern-error="The value in E-mail Address is not a valid email address." data-drupal-selector="edit-email" class="form-email required form-control" data-msg-maxlength="E-mail Address field has a maximum length of 254." data-msg-email="E-mail Address does not contain a valid email." data-msg-required="E-mail Address field is required." data-msg-pattern="The value in E-mail Address is not a valid email address." type="email" id="edit-email" name="email" value="" size="60" maxlength="254" required="required" aria-required="true" /> </div> <div class="form-item js-form-item form-type-textfield js-form-type-textfield form-item-company-organization js-form-item-company-organization form-group"> <label for="edit-company-organization" class="control-label">Company / Organization</label> <input data-counter-type="character" data-counter-maximum="50" data-counter-maximum-message=" " class="js-webform-counter webform-counter form-text form-control" data-drupal-selector="edit-company-organization" data-msg-maxlength="Company / Organization field has a maximum length of 50." type="text" id="edit-company-organization" name="company_organization" value="" size="60" maxlength="50" /> </div> <div class="form-item js-form-item form-type-select js-form-type-select form-item-country js-form-item-country form-group"> <label for="edit-country" class="control-label">Country</label> <div class="select-wrapper"><select data-drupal-selector="edit-country" class="form-select form-control" id="edit-country" name="country"><option value="" selected="selected">- None -</option><option value="Afghanistan">Afghanistan</option><option value="Albania">Albania</option><option value="Algeria">Algeria</option><option value="American Samoa">American Samoa</option><option value="Andorra">Andorra</option><option value="Angola">Angola</option><option value="Anguilla">Anguilla</option><option value="Antarctica">Antarctica</option><option value="Antigua and Barbuda">Antigua and Barbuda</option><option value="Argentina">Argentina</option><option value="Armenia">Armenia</option><option value="Aruba">Aruba</option><option value="Ascension Island">Ascension Island</option><option value="Australia">Australia</option><option value="Austria">Austria</option><option value="Azerbaijan">Azerbaijan</option><option value="Bahamas">Bahamas</option><option value="Bahrain">Bahrain</option><option value="Bangladesh">Bangladesh</option><option value="Barbados">Barbados</option><option value="Belarus">Belarus</option><option value="Belgium">Belgium</option><option value="Belize">Belize</option><option value="Benin">Benin</option><option value="Bermuda">Bermuda</option><option value="Bhutan">Bhutan</option><option value="Bolivia">Bolivia</option><option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option><option value="Botswana">Botswana</option><option value="Bouvet Island">Bouvet Island</option><option value="Brazil">Brazil</option><option value="British Indian Ocean Territory">British Indian Ocean Territory</option><option value="British Virgin Islands">British Virgin Islands</option><option value="Brunei">Brunei</option><option value="Bulgaria">Bulgaria</option><option value="Burkina Faso">Burkina Faso</option><option value="Burundi">Burundi</option><option value="Cambodia">Cambodia</option><option value="Cameroon">Cameroon</option><option value="Canada">Canada</option><option value="Canary Islands">Canary Islands</option><option value="Cape Verde">Cape Verde</option><option value="Caribbean Netherlands">Caribbean Netherlands</option><option value="Cayman Islands">Cayman Islands</option><option value="Central African Republic">Central African Republic</option><option value="Ceuta and Melilla">Ceuta and Melilla</option><option value="Chad">Chad</option><option value="Chile">Chile</option><option value="China">China</option><option value="Christmas Island">Christmas Island</option><option value="Clipperton Island">Clipperton Island</option><option value="Cocos [Keeling] Islands">Cocos [Keeling] Islands</option><option value="Colombia">Colombia</option><option value="Comoros">Comoros</option><option value="Congo - Brazzaville">Congo - Brazzaville</option><option value="Congo - Kinshasa">Congo - Kinshasa</option><option value="Cook Islands">Cook Islands</option><option value="Costa Rica">Costa Rica</option><option value="Croatia">Croatia</option><option value="Cuba">Cuba</option><option value="Curaçao">Curaçao</option><option value="Cyprus">Cyprus</option><option value="Czech Republic">Czech Republic</option><option value="Côte d’Ivoire">Côte d’Ivoire</option><option value="Denmark">Denmark</option><option value="Diego Garcia">Diego Garcia</option><option value="Djibouti">Djibouti</option><option value="Dominica">Dominica</option><option value="Dominican Republic">Dominican Republic</option><option value="Ecuador">Ecuador</option><option value="Egypt">Egypt</option><option value="El Salvador">El Salvador</option><option value="Equatorial Guinea">Equatorial Guinea</option><option value="Eritrea">Eritrea</option><option value="Estonia">Estonia</option><option value="Ethiopia">Ethiopia</option><option value="Falkland Islands">Falkland Islands</option><option value="Faroe Islands">Faroe Islands</option><option value="Fiji">Fiji</option><option value="Finland">Finland</option><option value="France">France</option><option value="French Guiana">French Guiana</option><option value="French Polynesia">French Polynesia</option><option value="French Southern Territories">French Southern Territories</option><option value="Gabon">Gabon</option><option value="Gambia">Gambia</option><option value="Georgia">Georgia</option><option value="Germany">Germany</option><option value="Ghana">Ghana</option><option value="Gibraltar">Gibraltar</option><option value="Greece">Greece</option><option value="Greenland">Greenland</option><option value="Grenada">Grenada</option><option value="Guadeloupe">Guadeloupe</option><option value="Guam">Guam</option><option value="Guatemala">Guatemala</option><option value="Guernsey">Guernsey</option><option value="Guinea">Guinea</option><option value="Guinea-Bissau">Guinea-Bissau</option><option value="Guyana">Guyana</option><option value="Haiti">Haiti</option><option value="Heard Island and McDonald Islands">Heard Island and McDonald Islands</option><option value="Honduras">Honduras</option><option value="Hong Kong SAR China">Hong Kong SAR China</option><option value="Hungary">Hungary</option><option value="Iceland">Iceland</option><option value="India">India</option><option value="Indonesia">Indonesia</option><option value="Iran">Iran</option><option value="Iraq">Iraq</option><option value="Ireland">Ireland</option><option value="Isle of Man">Isle of Man</option><option value="Israel">Israel</option><option value="Italy">Italy</option><option value="Jamaica">Jamaica</option><option value="Japan">Japan</option><option value="Jersey">Jersey</option><option value="Jordan">Jordan</option><option value="Kazakhstan">Kazakhstan</option><option value="Kenya">Kenya</option><option value="Kiribati">Kiribati</option><option value="Kosovo">Kosovo</option><option value="Kuwait">Kuwait</option><option value="Kyrgyzstan">Kyrgyzstan</option><option value="Laos">Laos</option><option value="Latvia">Latvia</option><option value="Lebanon">Lebanon</option><option value="Lesotho">Lesotho</option><option value="Liberia">Liberia</option><option value="Libya">Libya</option><option value="Liechtenstein">Liechtenstein</option><option value="Lithuania">Lithuania</option><option value="Luxembourg">Luxembourg</option><option value="Macau SAR China">Macau SAR China</option><option value="Macedonia">Macedonia</option><option value="Madagascar">Madagascar</option><option value="Malawi">Malawi</option><option value="Malaysia">Malaysia</option><option value="Maldives">Maldives</option><option value="Mali">Mali</option><option value="Malta">Malta</option><option value="Marshall Islands">Marshall Islands</option><option value="Martinique">Martinique</option><option value="Mauritania">Mauritania</option><option value="Mauritius">Mauritius</option><option value="Mayotte">Mayotte</option><option value="Mexico">Mexico</option><option value="Micronesia">Micronesia</option><option value="Moldova">Moldova</option><option value="Monaco">Monaco</option><option value="Mongolia">Mongolia</option><option value="Montenegro">Montenegro</option><option value="Montserrat">Montserrat</option><option value="Morocco">Morocco</option><option value="Mozambique">Mozambique</option><option value="Myanmar [Burma]">Myanmar [Burma]</option><option value="Namibia">Namibia</option><option value="Nauru">Nauru</option><option value="Nepal">Nepal</option><option value="Netherlands">Netherlands</option><option value="Netherlands Antilles">Netherlands Antilles</option><option value="New Caledonia">New Caledonia</option><option value="New Zealand">New Zealand</option><option value="Nicaragua">Nicaragua</option><option value="Niger">Niger</option><option value="Nigeria">Nigeria</option><option value="Niue">Niue</option><option value="Norfolk Island">Norfolk Island</option><option value="Northern Mariana Islands">Northern Mariana Islands</option><option value="North Korea">North Korea</option><option value="Norway">Norway</option><option value="Oman">Oman</option><option value="Outlying Oceania">Outlying Oceania</option><option value="Pakistan">Pakistan</option><option value="Palau">Palau</option><option value="Palestinian Territories">Palestinian Territories</option><option value="Panama">Panama</option><option value="Papua New Guinea">Papua New Guinea</option><option value="Paraguay">Paraguay</option><option value="Peru">Peru</option><option value="Philippines">Philippines</option><option value="Pitcairn Islands">Pitcairn Islands</option><option value="Poland">Poland</option><option value="Portugal">Portugal</option><option value="Puerto Rico">Puerto Rico</option><option value="Qatar">Qatar</option><option value="Romania">Romania</option><option value="Russia">Russia</option><option value="Rwanda">Rwanda</option><option value="Réunion">Réunion</option><option value="Saint Barthélemy">Saint Barthélemy</option><option value="Saint Helena">Saint Helena</option><option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option><option value="Saint Lucia">Saint Lucia</option><option value="Saint Martin">Saint Martin</option><option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option><option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option><option value="Samoa">Samoa</option><option value="San Marino">San Marino</option><option value="Saudi Arabia">Saudi Arabia</option><option value="Senegal">Senegal</option><option value="Serbia">Serbia</option><option value="Seychelles">Seychelles</option><option value="Sierra Leone">Sierra Leone</option><option value="Singapore">Singapore</option><option value="Sint Maarten">Sint Maarten</option><option value="Slovakia">Slovakia</option><option value="Slovenia">Slovenia</option><option value="Solomon Islands">Solomon Islands</option><option 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