Culpeper County Volunteer Fire and Rescue Association
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Insurance Information

Instructions:

Forms:


Accident, Sickness and Workman’s Compensation Claims Directions

In the event of a claim, please follow the following steps:

  1. Please contact the Training Coordinator within 24 hours of injury.
    1. Wayne Green (OES-70)
      Cell: 540-423-2184
      Email: wgreen@culpepercounty.gov
      Dispatch: 540-727-7900
  2. At your earliest convenience contact :
    1. Armentrout Insurance Agency, LTD
      110 South East St.
      P. O. Box 1415
      Culpeper, Va. 22701
      Phone: 540-825-0494
      Fax: 540-825-8299
      Email:
      service@armentrountinsurance.com
  3. Immediate Supervisor must complete the Supervisor’s Incident Investigation form and fax it to the Training Coordinator within 24 hours.
  4. Injured member must have Light Duty Application completed and signed by Health Care Provider after each visit.

Notice: Please complete forms and take to the hospital or Doctor. If they have any questions, they can contact anyone above.

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