CLAIM FORM

CLAIM FORM

Claim Form

1Flight information

2Confirmation

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File number
Please fill in your flight information. If you had a connecting flight, please also fill in the connection flight information.
Departure airport*

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Final destination airport*

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Airline company*

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Flight number*
Flight date*
DD slash MM slash YYYY
Booking number*
Ticket number (ETKT)
Did you have one or more than one connecting flights ?*
- Yes
- No
You can add up to five (5) connecting flight
Connecting flight number*
Date of the connecting flight*
DD slash MM slash YYYY
Departure airport*

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Destination airport*

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Second connecting flight
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Flight number 2
Flight date 2
DD slash MM slash YYYY
Departure airport 2

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Destination airport 2

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Third connecting flight
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Flight number 3
Flight date 3
DD slash MM slash YYYY
Departure airport 3

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Destination airport 3

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Fourth connecting flight
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Flight number 4
Flight date 4
DD slash MM slash YYYY
Departure airport 4

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Destination airport 4

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Fifth connecting flight
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Flight number 5
Flight date 5
DD slash MM slash YYYY
Departure airport 5

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Destination airport 5

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The problem
Check the problem you encountered.
Problem with your flight*
- Flight delay
- Flight cancellation
- Overbooked flight
- Denied boarding
What was the total delay at your arrival to your final destination ?*
- Less than 3 hours
- More than 3 hours
- Never arrived
Did you miss a connecting flight as the result of the flight delay.*
- Yes
- No
What was the total delay at your arrival to your final destination ?*
- 0-1 hours
- 1-2 hours
- 2-3 hours
- More than 3h
- Never arrived
When were you informed about this flight disruption ?*
- Less than 14 days before departure
- More than 14 days before departure
Circumstances surrounding the flight disruption
What was the reason given to you by the airline ?*
- Technical problem (mechanical failure)
- Crew constraints
- Weather conditions
- Impacted by the delay of a previous flight
- Airport restrictions
- Strike
- I don’t know
- No reason given
- Other
Short explanation
(max 140 characters) (optional)
Tell us what happened
Please tell us any information that would help us proceed with your claim in a faster way. Did you get an alternative flight ? Have you already claimed to the airline ? Any information that you could provide will help us proceed with your claim.
Details about the circumstances
Flight Crew
- Lack of crew
- Flight crew exceeded its flight hours
Impacted by the delay of a previous flight
- Late arrival of the flight
- Impacted by the delay of a previous flight
If it was a strike*
- Airline crew
- Air traffic controllers
- Other
What was the total delay at your arrival to your final destination ?*
- 0-1 hours
- 1-2 hours
- 2-3 hours
- More than 3h
- Never arrived
Did you voluntarily give up your seat ?*
- Yes
- No
- Check-in counter closed
- Airline did not have proper information
Explain in a few words
For more information please contact us at : [email protected]

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Main passenger’s name*
First Last Name
Main passenger’s email address*
Enter your email address Confirm your email address
Main passenger’s phone number*
Full address*
Address 1 Address 2 City Province Postal code Country
Main passenger’s date of birth*
Number of passengers
Please enter a number from 1 to 12.
2nd passenger’s name*
First name Last name
2nd passenger’s email address*
2nd passenger’s age*
Please enter a number from 0 to 150.
3rd passenger’s name*
First name Last name
3rd passenger’s email address*
3rd passenger’s age*
Please enter a number from 0 to 150.
4th passenger’s name*
First name Last name
4th passenger’s email address*
4th passenger’s age*
Please enter a number from 0 to 150.
5th passenger’s name*
First name Last name
5th passenger’s email address*
5th passenger’s age*
Please enter a number from 0 to 150.
6th passenger’s name*
First name Last name
6th passenger’s email address*
6th passenger’s age*
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7th passenger’s name*
First name Last name
7th passenger’s email address*
7th passenger’s age*
Please enter a number from 0 to 150.
8th passenger’s name*
First name Last name
8th passenger’s email address*
8th passenger’s age*
Please enter a number from 0 to 150.
9th passenger’s name*
First name Last name
9th passenger’s email address*
9th passenger’s age*
Please enter a number from 0 to 150.
10th passenger’s name*
First name Last name
10th passenger’s email address*
10th passenger’s age*
Please enter a number from 0 to 150.
11th passenger’s name*
First name Last name
11th passenger’s email address*
11th passenger’s age*
Please enter a number from 0 to 150.
12th passenger’s name*
First name Last name
12th passenger’s email address*
12th passenger’s age*
Please enter a number from 0 to 150.
Terms and Conditions of Réclamation Vol En Retard inc. / Late Flight Claim Inc.

I. Definitions

Terms and Conditions of Réclamation Vol En Retard inc. / Late Flight Claim Inc.

1.1 The following defined terms are used herein:

Réclamation vol en retard inc. / Late Flight Claim Inc.: Réclamation vol en retard inc. / Late Flight Claim Inc. is incorporated under the Canadian Business Corporations Act and is concurrently governed by the Loi sur le Barreau du Québec. The head office of the corporation is located at 4905 Lapinière Blvd., Suite 3200, Brossard (Quebec) J4Z 0G2;

General Conditions: Late Flight Claim Inc.’s General Conditions which are described herein;

Claim: Any passenger’s Claim with an Airline Company in connection with a flight delay, cancellation or denied boarding;

Airline Company: The Airline Company which flew/provided the delayed or cancelled flight or that was supposed to do so;

Contract: The agreement entered into by the Passenger and Lafe Flight Claim Inc. for the purpose of having the Passenger grant a Power of Attorney to the benefit of Late Flight Claim Inc. and/or entrust the latter with the mandate of obtaining and collecting any and all compensation amount arising from the Claim;

Passenger: The Late Flight Claim Inc.’s client, the latter being the Passenger presenting a Claim against the Airline Company;

Extrajudicial Proceeding: The drafting and transmission of correspondence (including Demand Letters), when and if deemed necessary by Late Flight Claim Inc., as well as the collection by any means of the compensation amounts arising from the Claim. Furthermore, this may also include managing negotiations (regarding the payment of the compensation amounts) with the Airline Company and reaching an amicable settlement with the latter;

Amicable Settlement: All actions taken by Late Flight Claim Inc. as representative of the Passenger, further to and only if need be, the filing of the Claim with the Airline Company, the transmission of any necessary follow-ups to the Airline Company and the transmission of a letter to the Airline Company advising of the imminent commencement of the legal proceeding, the whole including, amongst other things, and if deemed necessary, the drafting and transmission by Late Flight Claim Inc. of any related Demand Letters and other correspondence in connection with the Claim;

Legal Proceeding: The legal collection of any compensation amounts arising from the Claim by Late Flight Claim Inc. in its name or on behalf of the Passenger, including but without limiting the scope of the latter, the introduction of legal proceeding against the Airline Company, the management of negotiations (regarding the payment of the compensation amount) with the Airline Company and obtaining an amicable settlement with the Airline Company;

II. General Conditions

2.1 The General Conditions herein apply to all contracts which are entered into by Late Flight Claim Inc. and the Passenger.

2.2 Late Flight Claim Inc. offers a wide array of services with the goal of obtaining a compensation amount further to a late, cancelled or overbooked flight or in the case of denied boarding, the whole as prescribed under the Applicable Laws, including but not limited solely to, the Regulation (EC) No. 261/2004 of the European Parliament and the Regulation (EC) No. 261/2004 of the European Parliamant and the Air Passenger Protection Regulations (Canada).

2.3 If Late Flight Claim Inc. agrees to proceed with the Claim, it will do so by using appropriate and reasonable efforts to collect any compensation amount arising from the Claim with the Airline Company.

2.4 Late Flight Claim Inc. will manage the Passenger’s personal information with the utmost confidentiality and will extend the same degree of confidentiality to the personal information of any other passengers which accompanied the Passenger on his/her trip. The Passenger hereby grants to Late Flight Claim Inc. express consent to the utilisation of all of his/her personal information by Late Flight Claim Inc. in connection with his/her Claim with the Airline Company and understands that Late Flight Claim Inc. will utilise said personal information in the regular course of its business, the whole in accordance with the Act Respecting The Protection Of Personal Information In The Private Sector.

2.5 The Passenger authorizes Late Flight Claim Inc. to disclose his/her personal information to its employees when deemed necessary. The General Conditions herein also apply to the employees of Late Flight Claim Inc.

2.6 The Passenger will be informed as soon as possible on the course of action chosen by Late Flight Claim Inc. regarding the processing of his/her Claim and the perceived odds of obtaining a successful compensation amount from the Claim. However, no guaranty is made as to successfully obtaining any compensation amount in regards with the Claim.

2.7 If the Airline fails to process the Claim within a reasonable period after being notified by Late Flight Claim Inc., or if the Airline Company refuses to pay any compensation, Late Flight Claim Inc. may, at its sole discretion, initiate Extrajudicial Proceedings or Legal Proceedings against the Airline Company.

2.8 Late Flight Claim Inc. may update the Passenger on the status of his/her Claim by electronic communication (email). Late Flight Claim Inc. will not update the Passenger every time a change occurs in his/her file. The Passenger hereby declares understanding and agreeing to this process. Late Flight Claim Inc. is not responsible for any issues which may arise from the Passenger not taking cognizance of the electronic communication sent to him/her by Late Flight Claim Inc. regarding his/her Claim.

2.9 Late Flight Claim Inc. may refuse to represent the Passenger and to process his/her Claim and can at any time cancel the Contract without any need on its part to justify said cancellation, regardless of the stage in which the Claim is at and regardless of whether legal proceedings have been undertaken by Late Flight Claim Inc. From the moment Late Flight Claim Inc. signifies its interruption or refusal to process and manage the Claim, Late Flight Claim Inc. is no longer required to process the Passenger’s file relating to the Claim.

2.10 This agreement will be effective until the Passenger’s Claim is expressly closed by Late Flight Claim Inc. by way of written notice to that effect, whether the Claim resulted in a compensation amount being paid out by the Airline Company or the Passenger requested to close his/her file. In the latter case, section 8.9 of the present General Conditions will apply.

2.11 The Passenger agrees to retain the services of Late Flight Claim Inc. on an exclusive basis. The Passenger agrees not to interfere with the processing of the Claim and not to undertake any actions on his/her own in regard to the Claim. Nevertheless, the Passenger agrees to cooperate actively with Late Flight Claim Inc. to ensure the best course of action for his/her Claim. In any case, the Passenger agrees to inform and forward all communication received by the Airline Company with regards to his/her Claim. In the event where this section is not respected by the Passenger, the latter accepts and understands that Late Flight Claim Inc. will be authorized to unilaterally close his/her file and bill its standard hourly rate for all work accomplished in the Passenger’s Claim file up to that moment, in accordance with section 5.3 of the present General Conditions. All collection measures undertaken by Late Flight Claim Inc. regarding fees owing will be billed at an hourly rate of $200 and applicable taxes will be applied accordingly.

III. Extrajudicial Proceedings

3.1 The Passenger grants a Power of Attorney to Late Flight Claim Inc. for the collection of the compensation amounts arising from the Claim by way of Extrajudicial Proceeding, said Power of Attorney further grants Late Flight Claim Inc. with the authorization to undertake any and all actions necessary for Late Flight Claim Inc. to be able to receive the payment of said compensation amounts arising from the Claim.

IV. Amicable settlement

4.1 Late Flight Claim Inc. is the sole party granted with the right to determine whether an amicable settlement is the proper course of action to take in order to maximize the chances of obtaining a compensation amount arising from the Claim. Late Flight Claim Inc. will decide whether an amicable settlement is the right course of action further to an analysis of the Claim file and the evidence supplied by the Passenger in support of his/her Claim. Late Flight Claim Inc. reserves the right to refuse to entertain an amicable settlement proceeding if said proceeding is deemed unnecessary and unyielding of any positive settlement amount.

V. Legal Proceeding

5.1 Late Flight Claim Inc. is the sole party holding the right to determine whether legal proceeding is the proper course of action to maximize the chances of obtaining a compensation amount arising from the Claim. Late Flight Claim Inc. will determine whether legal proceeding is the right course of action further to an analysis of the Claim file and the evidence supplied by the Passenger in support of his/her Claim. Late Flight Claim Inc. reserves the right to refuse to entertain legal proceeding if said proceeding is deemed unnecessary and unyielding of any positive results for the Claim file.

5.2 If Late Flight Claim Inc. decides to undertake legal proceeding, the Passenger authorizes Late Flight Claim Inc. to proceed with the collection of any legal amounts arising from the Claim by means of obtaining an amicable settlement or by the application of executory measures, if need be.

5.3 The Passenger can cancel the Contract at any time, regardless of the status of his/her Claim file. In the event where the Passenger wishes to cancel his/her Claim file, Late Flight Claim Inc. will bill all fees and disbursements to the Passenger that it or any of its employees (attorneys) may have incurred during the processing of his/her Claim file. All work will be billed at an hourly rate of $200 and all applicable taxes will be added accordingly.

5.4 In order to successfully introduce a legal action against the Airline Company, the Passenger must do so in the delays prescribed by the applicable laws. This prescription delay is of two years in Canadian law but may vary according to the jurisdiction under which the legal proceeding is brought forward. The prescription delay commences from the moment the incident occurred (flight issue). By marking its acceptance of the present General Conditions, the Passenger recognizes that he/she fully understands the prescription delays that may be associated with his/her Claim file.

VI. Fees and Payments

Fees for Extrajudicial Proceeding and Legal Proceedings

6.1 No fees will be billed in advance or in anticipation to the Passenger for the use of the services provided by Legal Flight Claim Inc.

6.2 All amounts received as compensation amount arising from the Claim, but which is received after the Contract has ended will be automatically considered to be granted as compensation for the Claim due to the services rendered by Late Flight Claim Inc. in the Claim file, regardless of whether the Passenger performed any actions regarding his/her Claim file that could have benefited the resolution of the Claim. All amounts paid out by the Airline Company in connection with the Claim during the Internal Complaint Process will result in Late Flight Claim Inc. being entitled to receive 30% plus applicable taxes of said compensation payment. All amounts paid out by the Airline Company in connection to the Claim during the Legal Proceedings Process will result in Late Flight Claim Inc. being entitled to receive 45% plus applicable taxes of said compensation payment.

6.3 Payments by the Airline company paid out directly to the Passenger must be immediately, and no more than 14 days following receipt of the latter, transferred to Late Flight Claim Inc. The Passenger recognizes that 30% of any compensation amount arising from the Claim and received by the Passenger during the Internal Complaint Process will be owed to Late Flight Claim Inc. The Passenger recognizes that 45% of any compensation amount arising from the Claim and received by the Passenger during the Legal Proceedings Process will be owed to Late Flight Claim Inc. In the event where the Passenger omits to inform Late Flight Claim Inc. of the receipt of a compensation amount by the Airline Company, all services rendered by Late Flight Claim Inc. in the Passenger’s Claim file will be billed at an hourly rate of $200 plus applicable taxes. Furthermore, the Passenger understands and accepts that Late Flight Claim Inc. will be able to bill the Passenger all other fees which were incurred by Late Flight Claim Inc. during the processing of the Claim.

6.4 If after the commencement of the extrajudicial proceeding, but prior to the introduction of a legal proceeding, any compensation amount is paid out to the Passenger by the Airline Company in any non-pecuniary form, the Passenger will not be able to accept said compensation unless he/she has been authorized to do so by written notice from Late Flight claim Inc. The Passenger must never accept any compensation that would equate to less than the compensation amount expected for the Claim.

6.9 Legal proceedings will be undertaken as a collection measure for the Claim by Late Flight Claim Inc. based on the principle that « No payment shall be made without results ». No fees will be billed if no compensation was obtained from the Airline Company.

6.10 In the case where a partial or total payment of the compensation amount arising from the Claim is completed due to a legal proceeding action being successful, Late Flight Claim Inc. will bill 40% plus applicable taxes of said compensation amount to the Passenger. In the event where this compensation amount is directly paid to the Passenger, the latter agrees to transfer 40% plus applicable taxes out of the compensation amount to Late Flight Claim Inc. If a retainer had been transferred to Late Flight Claim Inc. by the Passenger, the amount of the retainer will be deducted from the 40%.

6.11 Any other amounts, including legal interests, allocated by the tribunals and that are not included in the compensation amount paid in connection with the Claim will atomically be the property of Late Flight Claim Inc., unless otherwise specified by way of written notice to that effect.

6.12 If further to the commencement of the legal proceeding the Passenger would be to accept any non-pecuniary compensation from the Airline Company, he/she will remain liable to Late Flight Claimed Inc. for an amount equating to 40% plus applicable taxes of the previously expected compensation amount arising from the Claim, unless otherwise expressly agreed between the Passenger and Late Flight Claim Inc.

VII. Payment

7.1 The amounts received by Late Flight Claim Inc. and destined for the Passenger will be paid out to him/her no later than 60 days following the reception of such amounts by Late Flight Claim Inc. The payment will be completed by way of electronic transfer to the Passenger’s bank account or by cheque.

7.2 Late Flight Claim Inc. declines all responsibilities for any negative consequences which may occur in the processing of the payment, whether it be regarding the banking data or postal information of the Passenger. If a foreign bank charges transaction fees for the electronic transfer of the payment, these fees will be charged back in their entirety to the Passenger.

7.3 If the Passenger is late in paying any amount destined to Late Flight Claim Inc., the latter will bill to the Passenger any and all late fees and disbursements incurred in obtaining said late payment, including its hourly rate fees of $200 plus applicable taxes, if case be.

VIII. Passenger’s Obligations

8.1 The Passenger declares that the information disclosed to Late flight Claim Inc. is exact, complete and truthful.

8.2 By marking its consent and agreement to the present General Conditions on the website of Late Flight Claim Inc., the Passenger declares having fully disclose all correspondence entertained between him/her and the Airline Company and any offers, discounts or any payment offered by the Airline Company in connection with the Claim.

8.3 The Passenger agrees to act according to the instructions provided by Late Flight Claim Inc. The latter is not responsible for the expiration of any prescribed delays due to neglect on the part of the Passenger.

8.4 At the end of the contract and for the entire duration of the extrajudicial proceeding and/or legal proceeding, the Passenger agrees not to communicate directly with the Airline Company, unless expressly authorized to do so by Late Flight Claim Inc. Late Flight Claim Inc. declines all responsibilities for any negative consequences experienced by the Passenger which arise out of the Passenger’s direct communication with the Airline Company.

8.5 The Passenger will immediately advise Late Flight Claim Inc. of all information and updates regarding his/her Claim.

8.6 If the contact information of the Passenger changes after the ending of the Contract, the Passenger will immediately notify Late Flight Claim Inc. of his/her updated contact information. Late Flight Claim Inc. is in no way responsible for any negative consequences which may arise from not having the updated contact information of the Passenger.

8.7 During the extrajudicial proceeding and/or legal proceeding, the Passenger is not authorized to transfer his/her Claim to a third party, unless he/she has been expressly authorized to do so by written notice by Late flight Claim Inc.

8.8 If the Passenger contravenes in any way to section 8.7 of the present General Conditions, or if he/she accepts an offer for compensation from the Airline Company, the Passenger accepts and understands that Late Flight Claim Inc. may bill all work completed during the processing of the Claim file to the Passenger at an hourly rate of $200 plus applicable taxes. The Passenger accepts and understands that all fees which were incurred during the processing of the Claim file will then be billed to the Passenger.

IX. Force majeure

9.1 Late Flight Claim Inc. will not be held responsible for not fulfilling any obligation towards the Passenger if its efforts to do so have been undermined or made impossible due to a case of force majeure and/or a situation which is out of its reasonable control, nor would Late Flight Claim Inc. be held liable for any unfulfilled obligation due to legislation or any legal acts or concepts generally accepted. Force majeure means: all external factors, predictable or unpredictable for which Late Flight Claim Inc. cannot exercise influence and due to which Late Flight Claim Inc. is not able to fulfill some or all of its obligations under the Contract and the present General Conditions.

9.2 Late Flight Claim Inc. can interrupt the fulfillment of any obligations it may have arising from Contract if a case of force majeure arises.

X. Cancellation – Void

10.1 If any of the provisions detailed herein are rendered nulled due to an applicable law, the latter provision will be deemed not to have existed, but this will in no way affect the legitimacy of the other provisions of the present General Conditions.

XI. Applicable Law and Jurisdiction

11.1 Any dispute with Late Flight Claim Inc. regarding the performance of the Contract shall be submitted to the Quebec courts, Canada, Montreal District. Quebec law governs the present Contract.

The place of acceptance and conclusion of the Contract is Montreal.
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