Required Claim Documents – Connecticut Foundation Solutions Indemnity Company, LLC

Upload Claim Documents

You are on the document upload page for CFSIC. This upload page can be used for uploading the points of evidence for both Type 1 and Type 2 applications for crumbling foundations. You MUST have previously completed an application on-line in order to utilize this page.

REQUIRED INFORMATION & UPLOAD PROCESS:

1. Claim Number: you will be asked to provide your unique ”Claim Number” which was generated upon successful completion of the on-line application. This number begins with “1E01E” and was displayed in your browser window as well as sent to you via email at the email address you provided.

2. Name: provide the first and last name of Claimant.

3. Files: to attach files, use the “browse” button below next to each point of evidence. Browse on your computer to the file location. (Hint: consolidate all your files to a folder and/or USB device to ease selection.)

NOTE: for any non-document files (i.e., video), please call 844-763-1207, option #3, for further assistance.

Claim Number*
(This number is located on the confirmation page and email you received after application submission.)
Claimant Name
First Last
You are now on the upload page. This is a common upload page that can be used for either a Type 1 or Type 2 claim. We help you by reminding you, under each upload box, whether the point of evidence you are uploading, in each case, applies to a Type 1 claim AND a Type 2 claim both...or just to a Type 1 claim OR a Type 2 claim separately.

Points of Evidence
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1.* Evidence of Current Ownership (i.e., local tax bill)
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Mandatory: for Type 1 claims and Type 2 claims
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1. Evidence of Current Ownership (i.e., local tax bill)
Max. file size: 25 MB.
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For Type 1 claims and Type 2 claims
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2.* Evidence of Original Construction During Calendar Year 1983 or Subsequent
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Mandatory: for Type 1 claims and Type 2 claims
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2. Evidence of Original Construction During Calendar Year 1983 or Subsequent
Max. file size: 25 MB.
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For Type 1 claims and Type 2 claims
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3*. Certificate of Completion (signed by building inspector) Provided Upon Completion of Foundation Replacement
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Mandatory: for Type 2 claims only
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3. Certificate of Completion (signed by building inspector) Provided Upon Completion of Foundation Replacement
Max. file size: 25 MB.
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For Type 2 claims only
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4*. Written Evidence of Replacement Work Completed (itemize all costs and expenses)
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Mandatory: for Type 2 claim only
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4. Written Evidence of Replacement Work Completed (itemize all costs and expenses)

Max. file size: 25 MB.

For Type 2 claim only


For a Type 2 claim only, a copy of your contractor’s original proposal to replace your foundation,
with either an amendment provided by the contractor or a letter on the contractor’s letterhead,
clearly listing the eligible concrete work the contractor performed for you, and including
a calculation by the contractor of the costs for that work.

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5*. Core Test or Other Lab Analysis Final Report
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Optional: for Type 1 claim and Type 2 claim
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5. Core Test or Other Lab Analysis Final Report

Max. file size: 25 MB.

For Type 1 claims and Type 2 claims


Evidence of a pyrrhotite core test is mandatory for a Type 1, Severity Class Code 1 application.
It is not required for a Type 1, Severity Class Code 2 or 3 if a licensed professional engineer
has certified that class code.


For a Type 2 claim, evidence of a pyrrhotite test can be submitted OR an engineer’s visual exam
written report can be submitted. For Type 2 claims, no severity class code is required in the engineer’s report.

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6.* Visual Examination Report (*)

Optional: for Type 1 claims and Type 2 claims
     (*) Form 1 MUST include severity class code

6. Visual Examination Report

Max. file size: 25 MB.

For Type 1 claims and Type 2 claims


A Connecticut-licensed professional engineer’s written examination report is mandatory 
for a Type 1, Severity Class Code 3 or 2 application, and where that engineer or another 
engineer has assigned a CFSIC severity class code. A professional engineer’s written 
examination report is optional for a Type 2 claim if a core test has already been submitted above.

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7.* Letter from Current (or Prior) Homeowner's Insurer on Pending, Denied or Paid (in-whole or in-part) Claim
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Optional: for Type 1 claims and Type 2 claims
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7. Letter from Current (or Prior) Homeowner's Insurer regarding Pending, Denied, or Paid Claim

Max. file size: 25 MB.

For Type 1 claims and Type 2 claims


You must upload a letter from your prior or current homeowner’s insurer indicating that 
your claim was accepted in whole or in part OR that your claim was denied, or is still pending.
If your claim was paid, in whole or in part, the letter must indicate the amount paid to you.

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8.* Letter from Current (or Prior) Homeowner's Insurer on Paid Claim (in-whole or in-part) with Settlement Amount
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Optional: for Type 1 claims and Type 2 claims
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8. Letter from Current (or Prior) Homeowner's Insurer on Paid Claim (in-whole or in-part) with Settlement Amount
Max. file size: 25 MB.
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Optional: for Type 1 claims and Type 2 claims
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File
Drop files here or
Max. file size: 20 MB.
Comments
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