The New York State Insurance Department's website provides access to an electronic copy of Regulation 68 (11 NYCRR Part 65), and that page address includes a link to Reg 68's appendix, which is a complete set of all prescribed no-fault claim forms, but is there anywhere on the Internet one can find each of the 15 individual forms, linked to separate documents? Not until today, and that anywhere is now here.
Bookmark this post if you would find it useful to have access to the 15 individual prescribed no-fault claim forms comprising the complete set. Those forms are the:
- NF-1A (Rev 1/2004) Cover Letter
- NF-1B (Rev 1/2004) Cover Letter
- NF-2 (Rev 1/2004) Application for Motor Vehicle No-Fault Benefits
- NF-3 (Rev 1/2004) Verification of Treatment by Attending Physician of Other Provider of Health Service
- NF-4 (Rev 1/2004) Verification of Hospital Treatment
- NF-5 (Rev 1/2004) Hospital Facility Form
- NF-6 (Rev 1/2004) Employers Wage Verification Report
- NF-7 (Rev 1/2004) Verification of Self-Employment Income
- NF-8 (Rev 1/2004) Agreement to Pursue Social Security Disability Benefits
- NF-9 (Rev 1/2004) Agreement to Pursue Workers' Compensation or N.Y.S. Disability Benefits
- NF-10 (Rev 1/2004) Denial of Claim Form
- NF-11 (Rev 1/2004) Additional PIP Subrogation Agreement
- NF-12 (Rev 1/2004) Lump-Sum Settlement Agreement
- NF-13 (Rev 1/2004) Election of Option -- Optional Basic Economic Loss Coverage
- NF-AOB (Rev 1/2004) Assignment of Benefits Form










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