Insurance Claim Form | Highline Electric Association.

Notice of Changes to Rules and Regs:

Highline Electric Association (HEA) proposes changes to its Rules and Regulations to become effective July 1, 2025. Specific changes can be viewed here.

Insurance Claim Form

Full Name

Phone

Address

City/Town

State/Province

ZIP/Postal Code

Date/Time of Loss

Location of Loss

City/Town

State/Province

What was the believed cause of damage?

Outage

Blinks

Surge

Other

Please explain incident:

On the date of loss was a call made to Highline Electric Association reporting the incident?

Yes

To the best of your knowledge, were there other people affected?

Yes

If yes, please explain:

What was damaged?

Estimated amount of damage:

Was it repaired?

Comments: