There are many reasons why you may need to change a name and/or address on a claim. Please review all the instructions carefully that are outlined below and that are included on the appropriate form(s). This includes instructions for completing the form(s) and instructions outlining what supporting documentation is required based on the reason for your change request.
All completed forms and supporting documentation should be submitted to the Special Deputy Receiver in one of the following ways:
Electronic Submission (preferable):
Submit your completed form(s) & supporting documentation via Email using the instructions below:
Paper Submission:
Include your completed form and supporting documentation and mail to:
Examination Resources, LLC
145 N. Main Street
P.O. Box 519
Stuart, VA 24171
The Special Deputy Receiver reserves the right to validate any name and/or address change request received and may request additional information from you.
If you are requesting an address change only, please select the Claimant Address Change Only Request Form below.
If you are requesting a name change, with or without an address change, please select the Claimant Name Change Request Form With or Without Address Change below.
Additional forms may be required for a name change. Please review the Claimant Name Change Request Form With or Without Address Change instructions to determine whether you are required to complete any of the forms provided below:
If you are requesting an assignment of your claim, please click here.
If you require additional assistance, please contact the Special Deputy Receiver by using this link: Contact Us.
Some companies specialize in purchasing claims and interests in distressed situations (specifically bankruptcies, liquidations and insolvent estates). Some claimants who have filed a claim in a receivership have received letters from such companies.
Such companies may submit public records requests asking for claims data which includes medical providers' claims information if they comply with the provisions of Florida Statute 631.195.
The decision of whether or not to accept the offer is entirely that of the claimant. The Receiver does not instruct, offer advice or make any comments to influence the claimant’s decision. Financial information regarding claims distributions and payments published on the Receiver’s website can assist the claimant in making an independent and informed decision regarding the sale of the claim. The purchase price being offered in exchange for the assignment may differ from the amount ultimately distributed in the receivership proceeding with respect to the claim.
Once the claim has been properly assigned, the Receiver’s records will be permanently changed and the claimant will no longer have any title, interest or rights to the claim including future mailings and distributions, if they occur. The form to assign the claim is available for download below.
Should you have any questions regarding this information or regarding the claim process, please visit our website at www.avatar-liquidation.com or call Consumer Services at 404-465-2814.
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