Yikes! It looks like you are using an older browser not supported by this site. For a bug free* experience please upgrade your browser. Check out whatbrowser.org to learn more about the browser you are using and your upgrade options.

*Bug free experience not guaranteed.
Report a Workers' Comp Claim Application Portal Safety Grant Portal Broker Dashboard
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

If calling during business hours, all calls are returned within the same business day. If calling after hours, please leave a message about your injury and you will be contacted within one business day by an intake specialist

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

All calls are returned within the same business day. If calling after hours, calls are returned within one business day.

Download the Three Ways to Report a Claim flyer.

Three Ways to Report a Claim:

  1. Call 609-543-3377 to speak to NJSIG's intake team. 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.
  2. Click here to complete online First Report of Injury (FROI)
  3. Download FROI: Click here for English | Click here for 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.

For Nurses and Supervisors Only: Complete our DDI Form

DDI Form

The Duty Determination Information (DDI) form should be completed by the nurse or supervisor at the time of injury. The injured worker should then provide the DDI to the treating doctor to complete. The DDI acts as authorization for the doctor's office to examine the injured worker. If an injury occurs after hours and a nurse/supervisor is not available to complete a DDI at the time of the injury, the DDI can be completed (by the nurse/supervisor) the next business day and sent post doctor's visit to the doctor's office.


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 Workers' Compensation Reporting Information:

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

Instructions for Reporting a New Workers' Compensation Claim

Download the Three Ways to Report a Claim flyer.

Workers' Compensation Materials

Workers' Compensation Digital Poster: English | Spanish

Workers' Compensation Digital Card: English | Spanish

Mitchell Card: English

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.