File an insurance claim

In order to file an insurance claim against the Borough of Somerville, you must complete the Notice of Claim Form within 90 days of your loss.

Need to know

  • Notify your insurance carrier first about your claim.
  • Under State Law (N.J.S.A. 59:9-2c) your insurance carrier must pay first.
  • The Borough, if legally liable for this loss, will pay only the uninsured portion of your claim.
  • It is necessary to prove that you do not have personal coverage for this incident by submitting a copy of your policy coverage or a declination letter from your insurance carrier.
  • The Borough is legally allowed up to 6 months to investigate and adjust your claim or prepare a defense.

Form instructions

  • Answer the questions on the form including all information available to the claimant or his/her attorney, agents, servants and employees under oath.
  • Return the completed Claim Form and requested documents to Kevin Sluka, Borough Clerk, Borough of Somerville, 25 West End Avenue, Somerville, New Jersey 08876.
  • Claim notices must be filed within 90 days after the incident
  • This is a general form for your use with respect to all claims. Some of the questions may not be applicable to your particular claim. For example, if your claim does not arise out of an automobile accident, questions regarding road conditions might not be applicable. In that event, please indicate “Not Applicable”.
  • If you are unable to answer any question because of lack of information available to you, specify the reason the information is not available to you.
  • If the question asks that you identify a document, it will be sufficient to furnish true and legible copies.
  • If the questions asks that you “identify all persons”, provide the name, address and telephone number of the person.
  • If you need more space to provide a full answer, attach supplementary pages and identify the continuation of the answer with the number of the applicable question.


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