UM Claims

Uninsured Motorist (“UM”) Claims

Individuals injured in an accident involving an uninsured automobile may be entitled to UM benefits if no other coverage is available. The UM claims’ process begins with the filing, within 180 days, of the accident of a Notice of Intention to Make a Claim (“NOI”) as required by N.J.S.A. 39:6-65. All statutory requirements of the Unsatisfied Claim and Judgment Fund Law, N.J.S.A. 39:6-61 et seq. must also be satisfied. An NOI form can be downloaded here.

What Documents Do I Need?

You must file a Notice of Intention to Make a Claim (“NOI”) with respect to your accident if you are seeking to file a claim with the UCJF. An NOI form can be downloaded here. In addition to the NOI, the Association requires the following forms which can be downloaded from the Forms library on the Association’s website:

Hand putting coin into car bank
PIP APPLICATION: FORM LINK

Form made in support of a claim. Must be fully completed and submitted to the Association.

AFFIDAVIT IN SUPPORT OF UCJF ELIGIBILITY:FORM LINK

Sworn statement made in support of a claim. Must be fully completed, notarized and submitted to the Association.

CERTIFICATE OF MEDICARE ELIGIBILITY: FORM LINK

Sworn statement made in support of a claimant’s Medicare beneficiary status. Must be fully completed and submitted to the Association.

HIPAA PRIVACY AUTHORIZATION: FORM LINK

Authorization for use or disclosure of protected health information pursuant to the Health Insurance Portability and Accountability Act.