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9611 SE 36th Street
Mercer Island, WA 98040
Phone: 206.275.7793
Fax: 206.275.7663
Contact: Deb Estrada, City Clerk
Email: deb.estrada@mercer. . .
Hours: 8:30 am - 5:00 pm (Mon - Fri)
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City of Mercer Island / City Clerk / Filing a Claim for Damages

Claims for Damages

The designated agent to receive claims for damages is the City Clerk, Deb Estrada. Claims may be submitted during regular business hours between 8:30 am and 5:00 pm, Monday through Friday, excluding legal holidays and other posted closures. The City Clerk's office is located at Mercer Island City Hall, 9611 SE 36th Street, Mercer Island WA, 98040. Phone inquiries may be directed to 206-275-7793.

Below is the link to download the City's Claim for Damages form as well as the WA State Standard Tort Claim Form (as required by RCW 4.96.020(C)).  Either form will be accepted by the City for a claim for damages.
City of Mercer Island Claim for Damages Form

WA State Standard Tort Claim Form

Filing a Claim for Damages - Frequently Asked Questions (FAQ)

Q: What is a Claim for Damages?
A: A claim is a request for payment for a loss, injury, or damages that you incurred in an incident/accident.
Q: What law regulates the City's claims process?
A: The claims process follows Washington State Law Revised Code of Washington (RCW) 4.96.020.
Q: How long do I have to file a claim?
A: You must file your claim within the state statute of limitations. There are different statutes of limitation for different types of claims. See RCW 4.16.160.
Q: I filled out a report when I was involved in the accident, do I still need to file a claim?
A: Yes. You must file a claim if you feel the City of Mercer Island is responsible for your loss, injury, or damages.
Q: How do I file a claim against the City of Mercer Island?
A: You can print a claim form, call for a claim form (206-275-7795), or pick up a claim form from City Hall (9611 SE 36th Street, Mercer Island, WA 98040).
Q: What information do I need to include on my form?
A: Claims must include:
  • The claimant’s name, date of birth and contact info;
  • A description of the conduct that brought about the injury or damage;
  • A description of the injury or damage;
  • A statement of the time and place that the injury or damage occurred;
  • A listing of the names of all persons involved and contact information, if known;
  • A statement of the amount of damages claim; and
  • A statement of the actual residence of the claimant at the time of presenting the claim and at the time the claim arose.
And, the form must be signed either:
  • By the claimant, verifying the claim;
  • Pursuant to a written power of attorney, by the attorney in fact for the claimant;
  • By an attorney admitted to practice in Washington on the claimant’s behalf; or
  • By a court-approved guardian or guardian ad litem on behalf of the claimant.
Q: Should I include any other documents?
A: It will help your claim to include any supporting records, such as receipts, estimates, and invoices, along with any additional evidence, such as photos, diagrams, etc. Documents filed with your claim become property and are public record.
Q: Where do I file my claim?
A: Claims for damages against the City must be filed in person or by mail to:
City of Mercer Island
ATTN: Deb Estrada, City Clerk
9611 SE 36th Street
Mercer Island, WA 98040
Q: What happens after I file my claim?
A: Your claim will be sent to the city’s insurance authority after it is submitted to the city. Mercer Island is a member of the Washington Cities Insurance Authority.
Q: When will an adjuster contact me?
A: An adjuster will generally contact you in writing within 2 to 3 business days after the assignment of your claim. Your assigned adjuster will identify the claim number and will request other  documentation needed to investigate your claim.
Q: How long will the investigation take?
A: The length of time it takes to investigate to claims will vary from case to case.  On average, claims take up to 60 days to resolve.
Q: What are the considerations in evaluating a claim?
A: The considerations in evaluating a claim include:
  1. The particular facts of the alleged loss,  
  2. The applicable law,  
  3. Whether the City of Mercer Island has legal responsibility,
  4. The claimant's role in the situation, and
  5. The nature and extent of damages claimed.


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