Find Agents

Claim Department
Contacts

Lynn Rupp

Senior Vice President – Claims
201-847-2848


Lisa Rosa

Vice President – Claims
201-847-2847


Gerald Steimers

Second Vice President – Claims
201-847-2899


Rosa Avella

Claims Administrative Assistant
201-847-2863


Required Fields *

Date of Accident *
Format XX/XX/XXXX
Time of Accident
Previously Reported?

CONTACT

Name *
Email
Address *
Business Phone
Residence Phone
Where to contact
When to contact

INSURED

Name *
Address *
Business Phone
Residence Phone
Where to contact
When to contact

COVERAGE

Policy Number *
Effective Dates of Coverage
From To
Agent's Name
Agent's Address
Agent's Phone

LOCATION OF LOSS

Reported to
Probable $ Amount of Entire Loss
$
Location (Include City and State)
Type of Loss
Description of Loss and Damage
Remarks
Reported by
FRAUD WARNING: It is a crime to knowingly provide false, incomplete, or misleading information to an insurance company for the porpose of defrauding the company. Penalties may include imprisonment, fines or denial of insurance benefits.