You MUST provide the following: 1) Photos of the damage; 2) Proof of the expense you wish to be reimbursed or at least TWO (2) estimates of the cost to repair/replace the damages; 3) Your insurance declarations page showing the coverages you have; 4) Your vehicle’s insurance, title, and registration (if applicable); 5) Police report or police report number (if applicable). Failure to provide this information will delay the claim process and could result in a denial of your claim. 

DO NOT START THIS FORM IF YOU DO NOT HAVE THE REQUIRED INFORMATION. 

PLEASE NOTE THE FOLLOWING:

1. Submitting a claim does not guarantee reimbursement to you for damages. The City of Grand Rapids reviews each claim on an individual basis.
2. Sewer backup claims MUST be filed within 45 days of the sewer backup or within 45 days from when you first discovered the backup. Please be reminded that City of Grand Rapids property owners are responsible for maintaining the sanitary sewer lateral from the house to the street.
3. Damage related to potholes is covered ONLY if the pothole you hit was reported to the City at least 30 days before.
4. Mailbox damage claims are ONLY covered if the snowplow or other city vehicle physically struck your mailbox.
5. Damage caused by weather-related events are not covered. 

For questions regarding this form or the claim process, please contact the Liability Analsyt at 616-456-4670 or email RiskClaims@grand-rapids.mi.us