Claims and Application

Victims of crime may be compensated for financial losses that are not covered by their own insurance, worker's compensation funds, Medicare, or restitution payments. Every claim that is filed is investigated to be sure it meets the necessary criteria.

Processing a claim takes time. The Victim Compensation Fund counts the time it takes to complete a claim from the time the claim is received until it is paid. Many crime victims measure the time from when the crime occurred until they are paid. Since victims have up to two years to file a claim, this sometimes creates a misunderstanding in just how long it takes to process the claim.

In order to process a claim, it must include the following:
         1.  Signed and notarized application
         2.  Copy of the law enforcement report
         3.  At least one itemized medical bill (all bills have to be itemized).

A funeral claim must include the following:
         1.  Signed and notarized application
         2.  Copy of the law enforcement report
         3.  Copy of the death certificate
         4.  The itemized funeral bill

Application Process

Applications are initially screened by an intake clerk to make sure applications are signed and notarized. Copies of itemized medical bills and a copy of the law enforcement report should also be attached to the application in order to continue the process and be assigned to a caseworker. Caseworkers conduct a thorough investigation to determine eligibility of the applicant.

Claim Investigation and Fraudulent Claims

Claim Investigation and Fraudulent Claims

Every claim filed will be investigated to determine that a crime was committed that resulted in physical injury or death and that the victim did not contribute to his or her injuries or sustain the injuries while engaged in illegal activity.

The crime must have been reported to law enforcement within 72 hours, unless good cause is shown and the victim (or the victim's legal representative) cooperated with all law enforcement agencies. Verification will be made that all requirements for receipt of an award have been or are being met.

If a false claim is deliberately filed the claimant will be subject to prosecution, the claim will be denied, and the claimant will have to repay any money awarded.

Victim Definition

Victim Definition

A victim is a person who suffers personal injury or death caused by criminally injurious conduct. Criminally injurious conduct means conduct which by its nature:
  * poses a substantial threat of personal injury or death
  * is punishable by a fine or imprisonment or death, and
  * does not result from a violation of the motor vehicle laws except:
      - in conduct related to DWI offenses
      - pedestrians who are victims of hit and run (wheelchairs and bicycles are allowed in definition for pedestrians).

Eligibility

Eligibility

Who may apply?
  * The victim.
  * A dependent of a deceased victim
  * A person who is authorized to act on behalf of a victim or dependent.
  * A third person who provided benefits to the victim or his/her family other than in the course or scope of his employment, business or profession.

Who is not eligible?
  * The offender.
  * A victim who is participating in criminal activity or contributory misconduct.
  * A victim who is a prisoner in any state, county or city prison, correctional, youth services or juvenile facility, or local confinement facility, or halfway house, group home or similar facility.

Payments

Payments

A maximum of $30,000 (plus an additional $5,000 for funeral expenses if the victim dies). Benefits are paid directly to service providers with the exception of out-of-pocket expenses paid by victim or claimant.

Please note that pursuant to N.C.G.S. 15B-2(1):
Allowable expense for medical care, counseling, rehabilitation, medically-related property, and other remedial treatment and care of a victim shall be limited to sixty-six and two-thirds percent (66 2/3%) of the amount usually charged by the provider for the treatment or care.  By accepting the compensation paid as allowable expense pursuant to this subdivision, the provider agrees that the compensation is payment in full for the treatment or care and shall not charge or otherwise hold a claimant finalcially responsible for the cost of services in addition to the amount of allowable expense.

Victims may be compensated for any reasonable charges incurred for reasonable needed products, services and accommodations including those for medical care, rehabilitation, medically related property and other remedial treatment and care. All available insurance or other health care assistance must be identified and used. (Medicare, Medicaid, health or auto insurance, etc.) The program does not compensate victims for damaged or stolen property.

Any collateral source such as Medicaid, or a public or private insurance plan must be filed when available. General Statute 15B states that assistance shall be denied or reduced to the extent the medical expenses are recouped through a public or private insurance plan or other victim benefit source.

Domestic Violence Household Support Benefit
Assists victims of domestic violence by providing $50 per week for each dependent child and is limited to 26 weeks. However, it shall not exceed $300 per week if the following conditions are met:

  • Must be married and living with their spouse at the time of the victimization.
  • Unemployed at the time of the victimization.
  • Has one or more children residing in the household at the time of the victimization.
  • The victimization occurred on or after October 26, 1998. If the victim moves back in with the spouse, the victim is no longer eligible for benefit.

Funeral Expense Benefit
The funeral expense benefit does not pay for flowers, gravestone, and other items not directly related to the funeral service. It does pay for:

  • Burial
  • Cremation
  • Transportation of body
  • Maximum of $5,000

What may be compensated?

  • Medical expenses (i.e. doctors, hospitals, lab tests, ambulance, therapy)
  • Counseling
  • Loss of wages
  • Funeral expenses - maximum of $5,000
  • Prosthetics
  • Eyeglasses
  • Dental work
  • Wheelchair ramp/widening of doors
  • Hospital bed
  • Crime scene cleanup such as door or window locks, car interiors (cleaning of blood)

What may not be compensated?

  • Pain and suffering
  • Property loss or damaged property

Work loss benefit
A claim for work loss will be paid only upon proof that the injured person was gainfully employed at the time of the criminally injurious conduct.

  • Copy of physician statement
  • Copy of employer's statement
  • Maximum of $300 per week
  • Maximum of 26 weeks

Requirements for compensation

  • Victim must be innocent of criminal activity and contributory misconduct.
  •  Services must be received within one year of date of incident, except for children 10 years-old or younger (they can have as much as two years of services that Victims Comp may pay for)
  • A notarized application. This application must be filed or received with Victims Compensation Services within two years of the date of the incident or date of disclosure with juvenile victims of sexual offenses.
  • Crime must be reported to law enforcement or warrant obtained within 72 hours from the date of the incident or show good cause for the delay.
  • Must fully cooperate with law enforcement and be willing to prosecute. · Must fully cooperate with Victims Compensation Services in requests for information or assistance.
  • Any collateral source such as Medicaid, or a public or private insurance plan must be filed when available.
  • The criminal act must have occurred in the State of North Carolina. If the crime occurs in another state, the application must be filed there. Victims may contact the Victims Comp office to obtain information about another state program.