claimsappcasualty.tmhcc.com Open in urlscan Pro
2606:4700:4400::6812:269f  Public Scan

URL: https://claimsappcasualty.tmhcc.com/
Submission: On July 18 via automatic, source certstream-suspicious — Scanned from US

Form analysis 1 forms found in the DOM

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Text Content

REPORT A CLAIM

Progress

-3%

Please complete your request within 2 hours. Otherwise the system will timeout
and the information you have provided may be lost.

SUBMIT/UPDATE A CLAIM - LET'S GET STARTED

Please select one:

I am entering a new claim
I am updating an existing claim (I have the claim reference number)



| Continue

FRAUD WARNING

×
Any person who knowingly and with intent to defraud any insurance company, or
other person, files an application for insurance or statement of claim
containing any false or misleading information or any fact material thereto,
commits a fraudulent insurance act, which is a crime.
Alabama: Any person who knowingly presents a false or fraudulent claim for
payment of a loss or benefit or knowingly presents false information in an
application for insurance is guilty of a crime and may be subject to fines and
confinement in prison.
Alaska: Any person who knowingly presents a false or fraudulent claim for
payment of a loss or benefit or knowingly presents false information in an
application for insurance is guilty of a crime and may be subject to fines and
confinement in prison.
Arizona: Any person who knowingly presents a false or fraudulent claim for
payment of a loss or benefit or knowingly presents false information in an
application for insurance is guilty of a crime and may be subject to fines and
confinement in prison.
Arkansas, Louisiana, West Virginia: Any person who knowingly presents a false or
fraudulent claim for payment of a loss or benefit or knowingly presents false
information in an application for insurance is guilty of a crime and may be
subject to fines and confinement in prison.
California: For your protection, California law requires the following to appear
on this form: Any person who knowingly presents false or fraudulent information
to obtain or amend insurance coverage or to make a claim for the payment of a
loss is guilty of a crime and may be subject to fines and confinement in state
prison.
Colorado: Any person who knowingly presents a false or fraudulent claim for
payment of a loss or benefit or knowingly presents false information in an
application for insurance is guilty of a crime and may be subject to fines and
confinement in prison.
Delaware: Any person who knowingly presents a false or fraudulent claim for
payment of a loss or benefit or knowingly presents false information in an
application for insurance is guilty of a crime and may be subject to fines and
confinement in prison.
District of Columbia: WARNING: It is a crime to provide false or misleading
information to an insurer for the purpose of defrauding the insurer or any other
person. Penalties include imprisonment and/or fines. In addition, an insurer may
deny insurance benefits if false information materially related to a claim was
provided by the applicant.
Florida: Any person who knowingly presents a false or fraudulent claim for
payment of a loss or benefit or knowingly presents false information in an
application for insurance is guilty of a crime and may be subject to fines and
confinement in prison.
Idaho: Any person who knowingly presents a false or fraudulent claim for payment
of a loss or benefit or knowingly presents false information in an application
for insurance is guilty of a crime and may be subject to fines and confinement
in prison.
Indiana: A person who knowingly and with intent to defraud an insurer files a
statement of claim containing any false, incomplete, or misleading information
commits a felony.
Kentucky: Any person who knowingly presents a false or fraudulent claim for
payment of a loss or benefit or knowingly presents false information in an
application for insurance is guilty of a crime and may be subject to fines and
confinement in prison.
Maine, Tennessee, Virginia, Washington: Any person who knowingly presents a
false or fraudulent claim for payment of a loss or benefit or knowingly presents
false information in an application for insurance is guilty of a crime and may
be subject to fines and confinement in prison.
Maryland: Any person who knowingly presents a false or fraudulent claim for
payment of a loss or benefit or knowingly presents false information in an
application for insurance is guilty of a crime and may be subject to fines and
confinement in prison.
Minnesota: Any person who knowingly presents a false or fraudulent claim for
payment of a loss or benefit or knowingly presents false information in an
application for insurance is guilty of a crime and may be subject to fines and
confinement in prison.
New Hampshire: Any person who, with a purpose to injure, defraud or deceive any
insurance company, files a statement of claim containing any false, incomplete
or misleading information is subject to prosecution and punishment for insurance
fraud, as provided in RSA 638:20.
New Jersey: Any person who knowingly presents a false or fraudulent claim for
payment of a loss or benefit or knowingly presents false information in an
application for insurance is guilty of a crime and may be subject to fines and
confinement in prison.
New Mexico: Any person who knowingly presents a false or fraudulent claim for
payment of a loss or benefit or knowingly presents false information in an
application for insurance is guilty of a crime and may be subject to fines and
confinement in prison.
New York: Any person who knowingly presents a false or fraudulent claim for
payment of a loss or benefit or knowingly presents false information in an
application for insurance is guilty of a crime and may be subject to fines and
confinement in prison.
Ohio: Any person who, with intent to defraud or knowing that he is facilitating
a fraud against an insurer, submits an application or files a claim containing a
false or deceptive statement is guilty of insurance fraud.
Oklahoma: Any person who knowingly presents a false or fraudulent claim for
payment of a loss or benefit or knowingly presents false information in an
application for insurance is guilty of a crime and may be subject to fines and
confinement in prison.
Oregon:Any person who knowingly and with intent to defraud or solicit another to
defraud an insurer: (1) by submitting an application, or (2) by filing a claim
containing a false statement as to any material fact thereto, may be committing
a fraudulent insurance act, which may be a crime and may subject the person to
criminal and civil penalties.
Pennsylvania: Any person who knowingly presents a false or fraudulent claim for
payment of a loss or benefit or knowingly presents false information in an
application for insurance is guilty of a crime and may be subject to fines and
confinement in prison.
Vermont: Any person who knowingly presents a false or fraudulent claim for
payment of a loss or benefit or knowingly presents false information in an
application for insurance is guilty of a crime and may be subject to fines and
confinement in prison.
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