What we may pay for

• Medical/Dental treatment
• Medication
• Mental health treatment
• Grief counseling
• Partial wage loss replacement
• Funeral expenses
• Expenses not covered by other insurance (such as medical co-pays and medical deductibles)

How much we may pay

How much we cover depends upon your insurance, and your situation.

Maximum per claim: $190,000

• Medical/Mental Health treatment: $150,000 maximum
• Wages (payments are based on 60% of the victim's wages)
• Family benefits of homicide victims: $40,000 maximum, includes burial expenses
• Benefits to crime victim:
  • Temporary wage loss benefit (returning to work): up to $15,000
  • Permanent total disability wage loss benefit: up to $40,000
• Burial expenses: up to $6,620

We don't pay for the following

• Crime scene cleanup
• Identity theft
• Loss or damage of personal property

To qualify for benefits you must have:

• Sustained a physical injury or mental health trauma as a result of a gross misdemeanor or felony crime in Washington State.
• Reported the crime to law enforcement and cooperated with the investigation.
  • File a report with law enforcement within one year from the date of crime or within one year from when it reasonably could have been reported.
• Submit a timely application.
  • Submit an application for benefits within three years of the crime being reported to law enforcement. Or, up to five years from the police report in certain circumstances.
  • For minors, at the time of the crime, the application must be filed within two years of their 18th birthday.

Circumstances vary and the laws are complex. To determine if you qualify for benefits please file a claim.

Claims filed under these circumstances may be denied.

If your injuries occurred:

• While committing a felony
• During incarceration
• As the result of your consent, provocation or incitement.

Or, if you owe restitution or fines from a violent offense or crime against another person.

Circumstances vary and the laws are complex. To determine if you qualify for benefits please file a claim.

If you disagree with a decision, send us a protest within 90 days of receiving the decision. The more information you provide, the faster we can review the decision.

If you disagree with the follow-up decision, then submit an appeal to the Board of Industrial Insurance Appeals.

Common reasons we deny a claim:

• No police report filed.
• No signature on the application.

Travel expenses may be reimbursed under some circumstances:

• The travel must be more than 15 miles one way from your home, and the first and last 15 miles of travel are not payable.
• No other provider of the same type is available closer to your home.
• Travel must also be preapproved by your claim manager for one of the following:
  • Treatment for your accepted condition.
  • An independent medical examination requested by your claim manager.
  • Prescription eye glasses or contacts lost or damaged during an assault may be replaced in some cases.

How to get reimbursed

Use the Travel Reimbursement Request form (F800‑049‑000). Your request must be made within 1 year of the trip and must indicate the date, destination and reason for travel. Receipts are required for all expenses, except parking under $10. Travel costs are reimbursed at the current Washington state reimbursement rate. See the Domestic Per Diem Rates.