Claims Information for Healthcare Organizations

CLAIMS

Claims Reporting Guidelines

To ensure prompt handling of your claim, please follow the instructions below.

Report All Claims To

claims@jjnegley.com

For Questions or Assistance:

Please contact Maria Iula

862-286-3527

*Important Notice: Please do not report claims directly to Nationwide. Submitting claims through the contact above ensures proper processing and timely support.*

Insured's Name*
[a-zA-Z][a-zA-Z\s]{0,30}[a-zA-Z]
Insured's Contact Name*
[a-zA-Z][a-zA-Z\s]{0,30}[a-zA-Z]
Insured's Email Address*
Insured's Phone
Broker Agency Name
Broker Contact Name
[a-zA-Z][a-zA-Z\s]{0,30}[a-zA-Z]
Broker Email Address*
Broker Phone
Accord Form*
Filename
Size
Process
Status
Add Files
Additional Files:
Filename
Size
Process
Status
Add Files
Only PDF files may be uploaded at this time. Once you have completed the information above and attached your files please click the submit button.

Privacy Statement

In order to expedite this process, please provide as much of the following information as possible:

Insured’s policy number
Date, time and location of the loss/accident
Details of the loss/accident
Name, address and phone number of all involved parties
If applicable, name of law enforcement agency or fire department, along with the incident number.

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