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Claim Submission Process
New Jersey
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Click on the form and complete in its entirety.
NOTE: Blank fields may delay our ability to service your claim. |
Step 2
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Print or save the form to your hard drive. Please click on the First Report of Injury form found in the Forms, Documents, and Information section of this screen. |
Step 3
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To submit a claim:
E-mail (preferred method):
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
Toll Free Fax #: 877-782-3292
Toll Free Phone #: 877-782-3291
Standard Mail:
SUA Insurance Company
P.O. Box 06110
Chicago, IL 60606-6110
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Forms, Documents and Information
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For your convenience, please find the following forms, instructions, and resources:
SUA New Jersey Claim Kit
Form IA-1 – First Report of Injury (FROI)
This form is required to be completed by the employer immediately following an employee injury or accident.
To Request Workers' Compensation Posting Notices and Template Stickers click here.
Claim Questions
Inquiries should be directed to: 877-782-3291
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Workers Compensation