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
   • 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 Louis Greco, Esq. with
   • Claim Transmittal Form 
     Louis Greco
     800 Route 50, Suite 2B
     Mays Landing, NJ 08330

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
   • 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

1. Call Beazley Environmental Claims at (800) 347-4384
2. Complete or have completed
   • SPELL Mold Claim Report Form 2020-2021
3. Forward copy of completed form to Beazley Claims
   • Fax: (860) 679-0247
     Email: enviro.claims@Beazley.com
4. Contact one of the JIF Administrators
   • Scott Tennant 
     Phone: (856) 446-9181
     Email: scott_tennant@riskprogramadministrators.com
   • Brad Hoffman 
     Phone: (856) 446-9132
     Email: brad_hoffman@riskprogramadministrators.com

---

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

SPELL JIF Policy # 1000600296201 for the Policy Period: 07/01/20 to 07/01/21

For additional assistance, contact one of the JIF Administrators

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

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

---

STUDENT ACCIDENT CLAIM

To access a Claim Form, please click below:

• K-8 English 2020-21 Student Accident Form
• K-8 Spanish 2020-21 Student Accident Form
• K-12 English 2020-21 Student Accident Form
• K-12 Spanish 2020-21 Student Accident Form

For Questions or Issues Regarding a Claim contact:

• Program Claims Coordinator
  Ms. Fran Eddis
  Phone: 856-890-7134
  Fax: 856-673-5927
  Email: feddis@hig.net
• Program Service Manager
  Ms. Bonnie Ridolfino
  Phone: 856-890-7138
  Fax: 856-673-5958
  Email: bridolfino@hig.net