North Jersey Claims  
 Association

To become a member please complete the below Membership Application.  Membership is good for one year, the following twelve months from the date of application.  The candidate for membership shall submit the completed Application Form with all required annual dues to the Membership Board of NJCA.  The application is subject to the approval of the Officer Board & the Committee Membership Board of N.J.C.A – (ie: Pres. VP, Treasurer or Secretary, and/or Honorary Officer.)

Insurance Claims Professional/Insurance Related Professionals: Annual Membership Fee $15.00

Any claim department head, supervisor, claims representative/examiner, nurse, house counsel, or independent claims representative primarily engaged in the handling, investigating & /or settling of insurance claims on behalf of Insurance Companies, Self-Insured, Public Utility Companies, and Government Agencies shall be eligible for membership.

Marketing Professional: Annual Membership Fee $100.00

Those individuals who service the Insurance Professionals (as described above) by way of expert knowledge & advice are eligible for membership.  These individuals must exhibit that they are principally engaged in furthering the interests of the Insurance Industry that Insurance Professionals retain their services.

Annual Membership Dues:

Each application for membership shall include $15/$100 (whichever applicable), which will serve as the membership fee 12 consecutive months following your application.  Checks should be made payable to the North Jersey Claims Association.

Please remit dues to: 

Claims Association, PO Box 338, Cedar Knolls NJ  07927

Applicant

Name/Title:__________________________________________________________________________________

Business

Name/Address:_______________________________________________________________________________

Phone:______________________________________________Email___________________________________

Home/Address:__________________________________________________________________________

Date:________________________________Amount Enclosed________________________$15.00/$100.00