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NJSIG Celebrating 40 Years!
Plan of Risk Management

Reporting Claims

Call NJSIG:

Call us at 609.386.6060  Monday — Friday | 8:30 AM — 4:30 PM.

Workers' Compensation Claims: 609.543.3377  Monday — Friday | 8:00 AM — 5:00 PM


For Emergencies:

If you have a loss occurring after business hours that needs immediate attention, please call 609.369.0535.

Please complete the claims ACORD reporting form and email to froi@njsig.org or fax to: 609.386.2188.

Workers' Compensation Accident Reporting Guidelines:

NJSIG's Workers' Compensation Intake Reporting: 609.543.3377

Business Hours: Monday — Friday | 8:00 AM — 5:00 PM

Three Ways to Report a Claim:

  1. Call 609-543-3377 to speak to NJSIG's intake team during standard business hours. The injured employee will be directed to treatment. English and Spanish team members available.
    1. If calling after standard business hours, please leave a message about your injury and you will be contacted within one business day by an intake specialist.
  2. Complete First Report of Injury (FROI): Complete Online
  3. Download FROI: English | Spanish
    1. Please email fully completed FROI forms to froi@njsig.org or fax to 609-386-2188.

If you indicated a need for treatment on the FROI form, you will be contacted by a workers' compensation specialist in 24 to 48 business hours.


In case of emergency:

  • The employee should report directly to an emergency room for treatment.
  • Once the employee leaves for the emergency room, or EMS personnel have left with the injured worker, please call to report the injury.
  • Upon discharge, or when the employee's condition is stable, the employee must call NJSIG.

Complete our DDI Form:

DDI Form

The Duty Determination Information (DDI) form should be completed and given to the treating doctor to fill out if the injured worker is to be sent to an occupational health facility or an urgent care. The DDI acts as authorization from the doctor's office to examine the injured worker.


If you have any questions, please feel free to call 609.386.6060 and speak with one of the workers' compensation Supervisors:

  • Gabe Foeldes: x3016
  • Denise Hall: x3092
  • Karen Olsen: x3022
  • Michael Weiner: x3026

Additional Worker's Compensation Reporting Information:

Instructions for Reporting a New Workers' Compensation Claim: Training Video

Instructions for Reporting a New Workers' Compensation Claim

Workers' Compensation Reporting Materials

Workers' Compensation Digital Poster: English | Spanish

Workers' Compensation Digital Card: English | Spanish

Auto/General Liability/Property/Equipment Breakdown/Environmental (Pollution) Acord Reporting Forms:

Acord Reporting Forms are available online and for download.

Errors and Omissions Claim Reporting Information:

Effective July 1, 2015, E & O claims are processed and handled by Summit Risk Services.

New losses should be emailed to: NJSIGCLAIM@SUMMITRISK.COM. If you currently report your claims through your broker, please continue to do so. Your broker will forward the claim to Summit for you.

The primary contact at Summit Risk Services is Richard Pevner, Vice President. Telephone 215-443-3596; cell phone 804-335-8000.

Email: pevner@summitrisk.com

Mailing address/office location is:

220 Gibraltar Road
Suite 100
Horsham, Pa. 19044

Should you have any questions, please contact us at 609-386-6060.

Cyber Liability Reporting:

Claims and Privacy Breach reports should be sent directly to Beazley. Please also send a notification of the filing to NJSIG at froi@njsig.org.

Claims

Beazley Group
Attn: TMB Claims Group
1270 Avenue of the Americas, 12th Floor
New York, NY 10020

Fax: 646-378-4039

Email: bbr.claims@beazley.com

Privacy Breaches

Email: bbr.claims@beazley.com

Toll-Free 24-Hour Hotline: 1-866-567-8570

Cyber Resources

Managing Catastrophic Events

Our Catastrophic Events provides information and tips for dealing with catastrophic events and extreme weather that will hopefully make this process easier for you.