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•Who may file a claim against the Coast Guard?

Anyone (e.g., an individual, a country, a territory, a partnership, or an association).
•What is a claim?
A demand for payment, made from any member of the community, against the Coast Guard, for damage or loss arising from the Coast Guard’s action.
•I think I have a claim. What do I do?
If you think you have a claim for damage, injury, or death, against the Coast Guard, you need to fill out a SF-95 and mail it to LSC-5E.
    Legal Service Command (LSC-5E)
    US Coast Guard
    300 East Main Street, Suite 400
    Norfolk, VA 23510-9100
•When should I use the SF-95?
Any time you request an administrative resolution of your claim.
Note: A SF-95 is not required for Admiralty claims but we recommend using the form to ensure that you provide all of the required information.

•Where can I find a SF-95?
Click here for a printable copy of the SF-95 .
•I am not sure what to enter in a certain Block on the SF-95.
    What should I do?
Read the SF-95 instruction contained on page 2 of the SF-95 form
Use the Line by Line Instructions contained within this webpage by moving your cursor over the applicable block.
Note: That these comments are for instructional purposes only and are not intended to be legal advice.
If you still have questions regarding the SF-95, you may call the LSC at (757) 628-4212, or e-mail us at:
D05-SMB-Claims@uscg.mil
•I have completed the SF-95. Now what do I do?
1. Make sure the SF-95 is completed and signed in ink.
2. Attach any and all supporting documentation to the SF-95.
3. Send the completed and signed SF-95, with any and all supporting documentation to:
    Legal Service Command (LSC-5E)
    US Coast Guard
    300 East Main Street, Suite 400
    Norfolk, VA 23510-9100

•What are examples of supporting documentation for the SF-95?
    •Two estimates for repair or 1 itemized repair bill (once repairs are made)
    •Pictures of damaged property
    •Rental car receipts
    •Witness Statements
    •Police reports
    •Any other documentation that supports the amount claimed
•If I am claiming personal injury, what supporting documentation should I      provide?
    • Medical bills
    • Doctor reports (e.g., ambulance and emergency room records, in-patient and out-patient records, doctors’ and nurses’ notes, x-rays, lab reports, and any other reports prepared in connection with diagnosis and treatment).
    • Lost wages
    • Any information that helps describe or support your personal injury amount.

•Can I submit the SF-95 electronically?
No. The original SF-95 must be signed in ink and mailed to the LSC office.
    Legal Service Command (LSC-5E)
    US Coast Guard
    300 East Main Street, Suite 400
    Norfolk, VA 23510-9100

•I filled out a SF-95. Where do I mail it?
Send the completed and signed SF-95, with any and all supporting documentation to:
    Legal Service Command Norfolk
    LSC-5E, Claims Division
    300 East Main Street, Suite 400
    Norfolk, VA 23510-9100

If you have already submitted your claim form to an office other than LSC-5E you may contact LSC-5E to ensure we have received your claim form.

•I am an active duty military member not employed by the Coast Guard
    and I have a claim against the Coast Guard; what should I do?
The action you take and the forms you complete are fact dependent as a result of your military status, please contact the legal service command at:
    Legal Service Command (LSC-5E)
    US Coast Guard
    300 East Main Street, Suite 400
    Norfolk, VA 23510-9100


Contact Us

If you have questions, you can call us at (757) 628-4212, e-mail us at: D05-SMB-Claims@uscg.mil or write us at our mailing address:
    Legal Service Command (LSC-5)
    US Coast Guard
    300 East Main Street, Suite 400
    Norfolk, VA 23510-9100

 

I am an Investigating Officer for a potential administrative claim against the government. What should I know?

• You need to fill out a Letter Incident Report (LIR). ATTACH SAMPLE LIR or a CG-4112A for personnel claims.
• Report facts in a clear and concise manner.
• Avoid including your opinion of fault in the report.
• Sometimes it may be necessary to contact the claimant during your investigation. It is acceptable to contact the claimant during your investigation if you need specific information from the claimant but NEVER contact the claimant if they have retained counsel.
• Attached is a Checklist for Investigating Officers

What is involved in a Claims Investigation?

• As soon as possible after an incident that might give rise to a claim against the Coast Guard, the responsible unit should undertake an investigation.
• In most claims matters, the preferred investigation format is the Letter Incident Report (LIR). If the Claimant is a Coast Guard employee use CG-4112A as the format for the investigation.
• Refer to the Administrative Investigations Manual (AIM), COMDTINST M5830.1, and Chapter 2 of the Coast Guard Claims and Litigation Manual, COMDTINST M5890.9 for specific guidance.

How long do I have to complete an investigation?

• Claims investigations should be completed immediately after an incident and forwarded to LSC-5E no later than 45 days after the date of incident.

What forms are required for Personnel claims and where can I find each form?

• Personnel claims should b filled out by the claimant (Coast Guard or Civilian Employee) on form CG-4112.

• Personnel claims normally do not require full administrative investigations. Instead, units should use the CG-4112A, Claims Investigating Officer’s Report of Personal Property Claim.
• Page 2 of the CG-4111, which is an inventory sheet, may also be requested by the Settlement Officer when the claim involves damage to several items.

I received a SF-95. What do I do with the form?
• Mail the original to the LSC office immediately.
    Legal Service Command (LSC-5E) US Coast Guard 300 East Main Street, Suite 400 Norfolk, VA 23510-9100

I received papers from an attorney or insurance company regarding a CG-related incident. What do I do?

• Contact LSC immediately. Do not respond to the company or the attorney.
• If you receive a phone call please inform the attorney or insurance company that LSC-5, the Coast Guard’s Claims office is the responsible office. Provide them with our contact information. Contact LSC-5 and provide contact information for the attorney or insurance company.

 

 

Contact Us

If you have questions, you can call us at (757) 628-4212, e-mail us at: D05-SMB-Claims@uscg.mil or write us at our mailing address:
    Legal Service Command (LSC-5E)
    US Coast Guard
    300 East Main Street, Suite 400
    Norfolk, VA 23510-9100

•Who may file a personnel claim?

Coast Guard members;
Coast Guard Reservists engaged in training;
Civilians employed by the Coast Guard;
Public Health Service Officers detailed to the Coast Guard;
Authorized agent (with Power of Attorney) or legal representative (with retainer agreement) for the previously-listed parties; or
Survivors of the previously-listed parties in the following order of preference:
    o Spouse,
    o Child/Children,
    o Parent(s),
    o Sibling(s).
•What damages are covered?
Damage to or loss of personal property sustained incident to service of the military member or civilian employee of the Coast Guard.
•What are some examples of “personal property”?
Cars, stereos, CDs, computers, furniture, books, photographs, pets, sporting equipment, etc.
•What does the term “incident to service” include?
• Property located at government-owned or leased housing or onboard a military installation that was damaged, lost, or destroyed by hurricane, flood, earthquake, fire, vandalism, theft, or other unusual occurrence (including electrical power outages you did not cause);
• Property damaged or lost while traveling under government orders;
• Property damaged or lost during the performance of duty to alleviate a public disaster to save lives; or
• Property damaged or lost in use that is necessary for the performance of official duties and is used at the express direction or request of a superior authority.
•If I have private insurance, do I need to file with my insurance company before filing a claim against the Coast Guard?
• Yes. If the property was covered by insurance, you need to first file with your insurance company. You may then file a damage claim with the Coast Guard for any damage or loss not covered by your insurer.
• You may submit a claim for any deductible amount not waived by your private insurance.
Note: You are responsible for repaying the Coast Guard any amount that you recover from your insurer.
•I am a military member who was involved in an accident, but I am not a claimant against the government. I am in the middle of discussing a private settlement. What should I be aware of?
• Military members who are involved in car accidents and receive settlements should contact Coast Guard headquarters (CG-LCL) before settling. The Coast Guard has the right to request reimbursement for any and all medical care provided as a result of a third party’s action. It is in a military member’s best interest to contact CG-LCL before any settlement to ensure all medical costs are included in the settlement amount. You may contact CG-LCL at (202)372-3740
•Will I be reimbursed for the full replacement cost of the damaged or lost property?

No. Personnel claims against the Coast Guard are paid on the depreciated value of the cost of the damaged or lost personal property.

•What forms are required for Personnel claims?

• Claims by military members or civilian employees of the Coast Guard are under Personnel Claims and should be submitted on the CG-4112. Personal Property Claim form, which is available here.
CG-4112 and CG-4111 (page 2 only, which is an inventory sheet) need to be completed by you, or by your authorized agent or legal representative.
CG-4112A needs to be completed by the Investigating Officer (i.e., assigned by your Command) and endorsed by your Command.
•When do I use CG 4111?
• The CG-4111 is used to:
Document damage or loss arising from incidents other than the shipment of household goods. For such claims, complete Blocks 23b, 23c, 23e, and 23f. Attach the CG-4111 as supporting document to the completed CG-4112.

FINCEN handles household goods claims. A link to their website can be found here
•Examples of Personnel Claims that require a CG-4112?
• My personal property got damaged at work.
• My personal property got damaged on base.
• My personal property got damaged on a non-CG base.
• My personal property, located in a Coast Guard designated location, was damaged during a natural disaster.
•Whom do I contact with additional questions?
LSC-5E is solely responsible for the adjudication of all Coast Guard Personnel claims (except those arising from the transportation or storage of household goods (HHG)). Send Personnel claims directly to:
    LSC-5E, Claims Division
    Legal Service Command Norfolk
    300 East Main Street, Suite 400
    Norfolk, VA 23510-9100


•What if I have a Household Goods (HHG) claim?
Household goods claims are not handled by the LSC.
FINCEN handles the Coast Guard’s household goods claims. FINCEN’s website is available here: http://www.fincen.uscg.mil/hhg.htm
Household goods (HHG) claims should be forwarded directly to:
    Coast Guard Finance Center
    HHG Claims
    P.O. Box 4121
    Chesapeake, VA 23327-4121
    (757) 366-6504 or (757)366-6505

•I damaged someone’s property while completing the CG’s mission on the water. What should I do?
• Write a detailed account of the incident.
• Inform your command.
• Provide a SF-95 or inform the property owner that they can visit the LSC website if they want information on how to submit a claim.
• Note: The USCG is not a towing service. We should avoid providing towing services when a professional towing company is available.
•What is the U.S. Government’s current Rental Car Agreement?
• The U.S. Government Car Rental Agreement, Number 4 (the Agreement), effective October 15, 2010, is the Government’s current rental agreement with various rental car agencies. The Agreement is managed by The Defense Travel Management Office (DTMO).
•What does the Agreement provide?
• The Agreement provides liability coverage for an accident that occurs while an authorized military member or civilian employee is driving a rental vehicle for official travel and found to be acting within the scope of their duties.
•How can I ensure that a particular rental company participates in the Agreement?
• Use your Command’s designated official travel agency to make travel arrangements.
• For more information on renting cars on official travel, please see the DTMO website: .http://www.defensetravel.dod.mil/site/rental.cfm
Note: If a travel agent tells you that a rental car company does not offer a government rate, that particular rental car company does not participate in the Agreement.

•Do all vehicles need to be rented from a rental company participating in the Agreement?
• Yes. Coast Guard policy requires that members and employees rent from car rental locations that participate in the Agreement.
•What if I am going to a location in which there are no participating rental car companies?
• Consider using a government vehicle.
•What do I do if I am involved in an accident while driving a rental car?
• Report the accident immediately to the rental car company, the police, and your Command.
• Get a copy of the police report and a copy of the accident report filed with the rental car company.
• Contact LSC-5E Claims Division for assistance at (757) 628-4212.
• Your Command needs to complete a claims investigation as soon as possible.
• All documentation should be forwarded to:
    Legal Service Command (LSC-5E)
    U.S. Coast Guard
    300 East Main Street, Suite 400
    Norfolk, VA 23510-9100
•Should I purchase the Damage Insurance Coverage that the rental car company offers to make sure I am covered in case of an accident?
• INCONUS: No. In accordance with the Joint Federal Travel Regulations (JFTR), the rental car Damage Insurance Coverage cannot be reimbursed in the Continental U.S. (including Alaska, Hawaii, Puerto Rico, and U.S. Territories or Possessions).
• OCONUS: Depends upon location—check the JFTR.
•What is the difference between the government accident coverage and damage insurance coverage?
• The government accident insurance deals with a specific government rate that requires the rental company to cover all damage to their rental car. Damage insurance coverage covers the rental car and all other costs resulting from the incident, including damage to other vehicles.
• Note: Many times the government rate is more expensive than an internet price. You must obtain the government rate regardless of the cost.
•Must I use my Government credit card when renting a vehicle from a participating rental company?
• Yes. The Government credit card provides notice to the rental car company that you are traveling on official government travel. A participating rental agency may not refuse to accept the Government credit card.
•What if I don’t get the government rate and am in an accident?
• The rental car company will most likely charge your credit card for all damages.
• Please contact this office prior to discussing payment with the rental car company.
•What should I know prior to obtaining the rental car?
• If you get a rental car on your own, know that the “military rate” is not the same as the “government rate.” The military rate is a military discount through a rental car agency. The “government rate” is the rate that the rental agency charges the government.
• If you have the government rate, you will most likely see a GAR fee (a daily amount that the rental car company charges the government) on your rental car agreement contract. The Government Administrative Rate Supplement (GARS) fee is not mandatory, but is almost always included.
• For more information refer to the ISC CO Conf Rental Cars FAQs

•What should I know if I have an accident in the rental car?
• LSC-5E can help.
• Please contact LSC-5E early so we can communicate with the appropriate people inside the rental car company.
•What should I know prior to obtaining a duty vehicle?
• A contract is formed when a command rents a duty van. The rules are different for duty vehicles than for rental vehicles. Duty vans are normally not insured under the GARS agreement.
•Additional Information regarding Automobiles:
• The government is self-insured, which is why you do not need to go out and get insurance with TAD orders.
• If you get a demand letter for payment, call the LSC. Please have your rental agreement available, as well as a copy of your TAD orders. We will look at your rental car agreement to see whether you received the government rate through a participating agency.
•What do I do if I get a ticket while on orders?
• Pay it!!
• Tickets include: speeding tickets or tickets as a result of an accident (i.e. reckless driving, failure to stop).
• If you have a question about a ticket, call the LSC well in advance of the court date. It is in your best interest to call LSC immediately after the accident, or as soon as possible afterwards, so the LSC can help you.
•I got into an accident while on government orders, what do I do?
• Call the police. Include the police report in your file.
• Inform your unit of the accident.
• Give a SF-95 to a potential claimant at the scene.
• Complete a SF-91 as soon as possible and get the other driver’s information. Be as thorough as possible.

•How do auxiliarists submit a claim?

• Auxiliarists need to submit their claim through their chain of command to their Director. The LSC only accepts claims from the Director of Auxiliary.
• To visit the Auxiliarists’ website, please click here:

AuxCliams

Send the completed and signed Auxiliary Claims form, with any and all supporting documentation to:
    Legal Service Command (LSC-5E)
    US Coast Guard
    300 East Main Street, Suite 400
    Norfolk, VA 23510-9100

     


    Contact Us

    If you have questions, you can call us at (757) 628-4212, e-mail us at: D05-SMB-Claims@uscg.mil or write to at our mailing address:
      Legal Service Command (LSC-5E)
      US Coast Guard
      300 East Main Street, Suite 400
      Norfolk, VA 23510-9100