Fill - Free fillable CLAIMS POLICY To submit a claim for damages PDF form

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CLAIMS POLICY

To submit a claim for damages against Baltimore Gas and Electric Company (BGE), please

complete, sign, and return this form to the BGE Claims Department via email at

BGEClaims@exeloncorp.com, via mail at BGE Claims, P.O. Box 1475, Baltimore, MD 21203-

1475, or via facsimile to 443.213.6905.

PROVISION

OF THIS FORM IS NOT AN AGREEMENT TO PAY FOR DAMAGES

Upon return of this form and completion of an investigation, a BGE Claims investigator will

inform you if your claim is accepted or denied. Please be advised that BGE will not reimburse

for claims due to service interruptions, pursuant to the following sections of its Maryland Public

Service Commission-approved tariffs:

BGE Retail Electric Tariff:

Section 2.5 Loss or Damage from Failure to Supply: The Company is not liable for any loss, cost,

damage or expense to any Customer occasioned by the failure to supply electricity according to

the terms of the contract or by an interruption or reversal of the supply of electricity, if such failure,

interruption or reversal is due to storm, lightning, fire, flood, drought, strike or any cause beyond

the control of the Company, or any cause except willful default or neglect on its part.

Section 3.4 Loss or Damage from Use of Electricity: The Company is not liable for any loss, cost,

damage or expense to any part resulting from the use or presence of electrical current or potential

or appliance upon the Customer’s premises.

Retail Gas Tariff:

Section 2.5 Loss or Damage from Failure To Supply: The Company is not liable for any loss, cost,

damage or expense to any Customer occasioned by any failure to supply gas according to the

terms of the contract or by any interruption of the supply of gas, if such failure or interruption is

due to storm, lightning, fire, flood, drought, strike, or any cause beyond the control of the

Company, or any cause except willful default or neglect on its part.

Section 3.4 Loss or Damage from Use of Gas: The Company is not liable for any loss, cost,

damage or expense to any party resulting from the use or presence of gas in the Customer's piping

or appliances.

Claims relating to damages, injuries, interruptions of service or voltage irregularities that result

from acts of third parties, are not paid by BGE.

Claimants are required to furnish original repair bills or repair estimates as supporting proof of

alleged damages and losses. A final decision will not be rendered until such bills and estimates

have been received. Requests for such proof shall not be construed as an agreement to pay a

claim.

BGE does not engage in the repair of property of others allegedly damaged due to its operation

nor will it inspect damaged appliances or goods for the purpose of determining the nature or extent

of damage. Such inspections and repairs must be performed by contractors or agents of the

claimant’s choice. BGE does not recommend contractors or repair agencies.

BGE may inspect or appraise damaged property for the purpose of determining fair and reasonable

value. Payments will be made based on actual cash value. Waiver of inspection does not

constitute agreement as to the fair and reasonable value of the damaged property. Damaged

property should be photographed. Spoiled food, medicine or other perishable merchandise should

not be held for inspection but should be inventoried, photographed, listed and disposed of

according to good sanitary practice. Claimants have a common law duty to limit damaged and

minimize losses. Damages arising from a claimant’s failure to make repairs and minimize losses

will not be reimbursed.

BGE contractors are responsible for their own operations and carry mandatory liability insurance.

Claims relating to contractor activities will be referred to the contractor and its insurer for

processing. BGE will assist the claimant in the resolution of contractor claims.

Claimants who are customers of BGE are cautioned not to withhold payment of gas or electric

bills pending a decision on claims submitted, as doing so could result in collection action,

including the discontinuance of service.

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Please read this form in its entirety before completing. PLEASE PRINT.

Your Name _______________________________________________________________

Mailing Address _______________________________________________________________

Number and Street

____________________________________________________________________________

City State Zip

Home Phone __________________________ Cell Phone _____________________________

Email ________________________________ BGE Account No. _______________________

Location of incident ____________________________________________________________

Number and Street Nearest Cross Street

_________________________________________________________

City State Zip

Date and time of loss ___________________________

Loss related to: Gas ____

Electric____

Vehicle ____

Other ____

Weather conditions: Rain ____

Snow ____ Storm___ Wind____

Other ____

Briefly describe the events causing the damage/loss or personal injury. If known, include the name of

BGE employees or contractors involved. You may include pictures with your submittal.

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List the items damaged:

You must include make, model number and date of original purchase as

well

as purchase price. Enclose a written repair bill or estimate for each damaged item. If items

are not repairable, enclose a statement from a repairman stating the cost to repair would exceed the

cost to

replace, along with a copy of the original purchase receipt or a written estimate of the

replacement cost. Depreciation is taken on replacement items.

________________________________________________________________________________________________

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Insurance Company Name _______________________________ Policy Number ___________________

Have you submitted a claim with your insurance company? Yes ______ No _______

If yes, please provide the correspondence with your insurance company.

Claimant Signature ______________________________________ Date ________________________

(Type name here if signing electronically)

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