CITY OF PASADENA
CLAIMS INFORMATION SHEET
1. Complete the attached claim form by typewriter or in black ink.
2. Answer each inquiry on the claim form, providing full details for each.
3. Sign and date the claim on page 3.
4. Present a claim for death, personal injury or personal property damage within six months of the incident to
the City Clerk’s Office, 100 N. Garfield Ave. Room S228, P.O Box 7115 Pasadena, CA 91109-7215. See
Government Code Section 911.2 for other time limitations.
1. The claim will be r
eceived by the City Council and forwarded to the City’s Insurance and Claims
Specialist for investigation, processing and possible resolution.
2. If your claim was filed within the time permitted by law, State law requires that your claim is automatically
deemed denied by operation of law 45 days after the filing date. See California Government Code Section
912.4. The City will send you a notice of such denial automatically after 45 days have passed from the date
you filed your claim.
A word of clarification regarding automatic 45-day rejection notice is in order. This 45-day rejection notice is
sent without regard to the investigation or settlement status of your claim, since it is a State-mandated
rejection notice. Investigation or settlement discussion you may reach after such automatic 45-day notice is
not affected by this 45-day rejection notice.
The 45-day rejection notice will advise you that you have only six months thereafter to file a lawsuit.
Although review of your claim by the City, and settlement discussions with the City, may well continue
after the 45-day rejection notice and during this six-month period, the six-month filing deadline is binding;
you must comply with this six-month Statue of Limitations if your case if not resolved prior to expiration of
the six-month period. See Government Code Sections 913 and 945.6.
3. The City of Pasadena will seek to recover all costs of defense, including attorney’s fees and City resources
used in defending the case, in the event a lawsuit is filed against the City and it is determined that the lawsuit
was not brought in good faith and based on reasonable cause. See California Code of Civil, Procedure Sections
128.5, 1021.7 and 1038.
4. The submission of a false claim is a crime. See Section 72 of the California Penal Code.
5. Receipt of a claim form assignment of a “claim” number by the City Clerk does not waive any right the City
may have to object to the sufficiency or timeliness of the claim, or any portion thereof.
6. If you have any questions, please call Insurance and Claims Specialist at (626) 744-6773.