Application: Type 1

There are three ways in which you can file an application for the CFSIC program:

- Method #1: File electronically, which will enable your application to be processed more quickly, and where you will be assigned a claim registration number immediately upon submitting your application online.

- Method #2: Download and print a pdf version of the application, complete it and sign it by hand. Scan it, and attaching your scanned points of evidence, email it to ESIS at: cfsic@esis.com. Once ESIS receives your application and attachments by email, you will be assigned a claim registration number.

- Method #3: Download and print a pdf version of the application, complete it and sign it by hand. Take the application, attaching all your points of evidence, and put it in the U.S. Mail to ESIS at:

Connecticut Foundation Solutions Indemnity Company, Inc.
c/o ESIS ProClaim
82 Hopmeadow Street
Simsbury, CT 06070

Once ESIS opens your application received in the mail, it will be processed, and you will be assigned a claim registration number, which you will receive by email.

Here are some things to remember:

- If you file electronically, please be aware that we have no control over the Internet bandwidth available to you, the age and type of computer you’re using, the age of any software you may be employing to create documents, and whether you are using an older version of an Internet browser.

- Uploads may happen very quickly, or they may happen slowly, depending on the above.

- The electronic application is a three-step process:

Step 1: You complete the application. At the very end of the application you can sign it with your mouse (you place the mouse over the signature box and sign your name using the mouse), and then fill in your name and the date. You then go to the CAPTCHA window to prove you’re not a robot. Lastly, you hit the “Submit” button. At this point you have submitted your signed application WITHOUT your attachments, which is exactly what you need to do. You will immediately see a webpage providing you with a claim registration number

Step 2: What will pop up next on your computer screen is a page providing you again with your claim registration number. (No one has seen your claim yet, and your claim is not approved. This is merely a claim registration number to get you inside the system.) You will be able to print this page for future reference. Stay on this page. Scroll down the page until you see the “Upload Claim Documentation” link. Click this link. You will now enter Step 3.

Step 3: You will now see a new page. This page is the “points of evidence upload page.” This is where you will be able to upload your document attachments (points of evidence). You will need to enter your claim registration number from the Step 2 page (which will remain open, so that you can copy and paste your claim number from that page, if you wish, or simply type it in). You will also see spaces to type your first and last name. You must do this. Once you have entered your claim number, and first and last name, scroll down to the first point where you will be able to attach a document to upload. You will do this by hitting the “browse” button shown next to each item you will be uploading.

Clicking on the “browse” button for each point of evidence will enable you to attach the required attachment file from your computer, wherever you are keeping it on your computer, and upload it to the system. (Underneath each upload box you will see a reference showing you what is required for either a Type 1 or a Type 2 claim, or for both types of claims.) You will do this for each file you need to upload...file by file.

Once you are finished attaching all the files you need to upload, you will hit the “Submit” button at the bottom of the page. This will result in a page confirming that your documents have been received, and re-confirming your claim registration number.

Your application process will then be completed if the uploads are successful, and you will be notified by ESIS of your claim’s status, once evaluated.

To file your application online: go to the Type 1 electronic application

To download and print a pdf version of the application: go to the Type 1 pdf application