Report All Other Claims

These forms are now fillable forms to make things easier for all of you to navigate, complete and save an electronic copy for any future use.

---

GENERAL, AUTO & EDUCATORS LEGAL LIABILITY & AUTO PHYSICAL DAMAGE LOSSES CLAIMS

1. Complete
   • Incident Reporting Form
   • Liability & Auto Physical Damage Loss Claim Reporting Form
2. Read
   • Procedures for Handling Tort Claims
   If uncertain, call Qual-Lynx at (609) 653-8400
3. Follow
   • Tort Claim Action Checklist
4. Complete
   • Notice of Tort Claim Cover Letter
   • Tort Claim Form  (Word Doc)
   • Tort Claim Transmittal Form
5. Forward copies to Qual-Lynx with
   • Claim Transmittal Form 
     Qual-Lynx
     100 Decadon Drive
     Egg Harbor Township, NJ 08234
6. Forward copies to Pat Madden, Esq. with
   • Claim Transmittal Form 
     Patrick J. Madden, Esquire
     Law Office of Patrick J. Madden, LLC
     204 Glenwood Ave.
     Haddonfield, NJ 08033
     pjm@pjmaddenlaw.com 
     609-413-5635

For Questions or Issues Regarding a Filed Claim contact:

• Qual-Lynx Liability Unit Supervisor
  Ms. Barbara Maclean 
  Office: 609-833-2916
  Fax: 609-601-3188
  Email: bmaclean@qual-lynx.com

---

PROPERTY LOSS CLAIM

1. Property Loss Claim Advice
   • Property Loss Claim Pointers
   • Emergency Property Damage Claims Requirements and Response Agreement
   • Complete
     • Incident Reporting Form
     • Property Loss Claim Reporting Form Fillable Form
   • Forward copies to Qual-Lynx with
     • Claim Transmittal Form Qual-Lynx
       100 Decadon Drive
       Egg Harbor Township, NJ 08234

For Questions or Issues Regarding a Filed Claim contact:

• Qual-Lynx Property Unit Supervisor
  Mr. Joe Lisciandri
  Office: 609-601-3191
  Cell: 609-402-5218
  Fax: 609-601-3192
  Email: jlisciandri@qual-lynx.com

---

ENVIRONMENTAL (MOLD) CLAIM

Click on the link below to access the Environmental (Mold) Claim Page:

SPELL JIF Mold Report Claim Page    Fillable Form

---

CYBER LIABILITY CLAIM
In the event of an actual or suspected breach incident, click on the link below to complete claim form and Data Breach Hotline number:

SPELL JIF Cyber Incident Report Claim Form and Hotline Directions Fillable Form

SPELL JIF Policy # 1000600296211 for the Policy Period: 07/01/22 to 06/30/23

For additional assistance, contact one of the JIF Administrators

• Craig Wilkie 
  Phone: (856) 446-9128
  Email: craig_wilkie@rpadmin.com

• Scott Tennant 
  Phone: (856) 446-9181
  Email: scott_tennant@rpadmin
• Brad Hoffman 
  Phone: (856) 446-9132
  Email: brad_hoffman@ripadmin.com

---

STUDENT ACCIDENT CLAIM

To access a Claim Form, please click below:

• 2022-2023 Student Accident Claim Form K-8 Spanish
• 2022-2023 Student Accident Claim Form K-8
• 2022-2023 Student Accident Claim Form K-12 Spanish
• 2022-2023 Student Accident Claim Form K-12

For Questions or Issues Regarding a Claim contact:

Program Claims Coordinator:
Dominique McDuffie
Phone: 609-267-1453
Email: dmcduffie@hig.net

Program Service Manager:
Danielle Colaianni
Phone: 856-890-7136
Email: dcolaianni@hig.net