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21-Day PIP Notification

The list below contains the insurer addresses filed with the Department where 21-day notification of the commencement of medical treatment notices should be sent pursuant to N.J.A.C. 11:3-25 (PDF). The list is updated as further information is received.

21st Century Premier Insurance Company
Attention: Reyleen Wood, J. Mayer, or Karen Zapata 8055 E. Tufts Ave., Suite 600, Denver, CO 80237	Phone: 1-877-533-1211 Ext 699, 664, or 326 E-mail: networknewloss@networkadjusters.com

21st Century Centennial Insurance Company
Assigned Risk Claims Attention: Christopher Peppard PO Box 9053, Hicksville, NY 11802	E-mail: christopher.peppard@21st.com Phone: 1-800-603-9694 Fax: 516-688-1455

Accelerant National Insurance Company
Attention: Scott Truss Head of US Claims 400 Northridge Rd., Suite 800, Sandy Springs, GA 30350	Phone: 1-470-440-9716 E-mail: scott.truss@accelins.com

Accident Fund Insurance Company of America United Wisconsin Insurance Company
Attention: Mr. Joseph Wicks Senior AF Specialty Advisor 200 N. Grand Ave., Lansing, MI 48901-7990	Phone: 1-517-708-5099 E-mail: Joseph.Wicks@accidentfund.com

ACE Fire Underwriters Insurance Company ACE Indemnity Insurance Company ACE Insurance Company ACE Property and Casualty Insurance Company Atlantic Employers Insurance Company Indemnity Insurance Company of North America Insurance Company of North America Pacific Employers Insurance Company
Commercial Auto Attention: Dick Snyder Wilmington Claims Center 1 Beaver Valley Road, Wilmington, DE 19803 Phone: 302-476-6007 Fax: 302-476-6513	Personal Auto Attention: Douglas Smith 150 Allen Road, Suite 101, Basking Ridge, NJ 07920 Phone: 908-860-4634 Fax: 215-861-6498 E-mail: douglas.smith@acegroup.com

Accredited Surety and Casualty Company, Inc
Attention: Nathan Mathis 260 Lena Drive Aurora, OH 44202	Phone: 812-340-8916 E-mail: nate.mathis@novumuw.com

AIG Property Casualty Company AIU Insurance Company American Home Assurance Company Commerce & Industry Insurance Company Granite State Insurance Company Illinois National Insurance Company National Union Fire Insurance Company of Pittsburgh, Pa. New Hampshire Insurance Company (LAD)
Commercial Auto Attention: Sarah Hlad AIG Domestic Claims, Inc. Olathe Ops Center PO Box 25588, Shawnee Mission, KS 66225 Phone: 515-221-6824 Fax: 515-221-6805	Personal Auto Attention: William Murphy 1 Connell Drive - Suite 2100, Berkeley Heights, NJ 07922 Phone: 1-888-724-8881 Fax: 1-866-947-1512

Allied World National Assurance Company Vantapro Specialty Insurance Company
Attention: Karen Colonna, S.V.P. & Deputy General Counsel, U.S. Compliance 199 Water St., 24th Floor, New York, NY 10038	Phone: 646-794-0576 Fax: 646-794-0610 E-mail: Karen.Colonna@AWAC.com

Allied World Reinsurance Company
Attention: John R. Wilkens, CPCU, Vice President - Compliance, Allied World Assurance Company (U.S.), Inc. 199 Water St., 29th Floor, New York, NY 10038	Phone: 646-794-0580 Fax: 646-794-0811 E-mail: john.wilkens@awac.com

Allstate New Jersey Insurance Company Allstate New Jersey Property and Casualty Insurance Company
Attention: Linda Coleman 300 American Metro Blvd., Suite 220, Hamilton, NJ 08619	Phone: 1-888-710-3483 ext. 5656 Fax: 1-609-631-0925 E-mail: BCSupportUnit@Allstate.com

American Commerce Insurance Company
Attention: Edward Alejandro 901 Franklin Ave., Garden City, NY 11530	Phone: 516-564-8000 ext. 26307 Fax: 508-671-5317

American Compensation Insurance Company
Attention: Jay Carleton, Vice President - Casualty Claims 700 W. 47th St., Suite 350, Kansas City, MO 64112	Phone: 816-412-2829 E-mail: jcarleton@rhkc.com

American Family Insurance Group American Family Connect Property and Casualty Insurance Company
Attention: Stacy A. Bartz 3500 Packerland Drive, De Pere, WI 54115-9070	Phone: 920-330-5195 Fax: 920-330-5334
Midvale Indemnity Company
Commercial Auto Attention: Michael Rogers K2 Insurance Services LLC 11452 El Camino Road, Suite 250, San Diego, CA 92130 Phone: 1-610-708-5577 E-mail: mrogers@t2greeninsurance.com	Personal Auto Attention: Barb Siegel - Scanning Center 6000 American Parkway, Madison, WI 53783-0001 Phone: 1-866-922-4059 Fax: 1-866-833-5599 E-mail: bsiegel@amfam.com

American Modern Property & Casualty Insurance Company
Attention: Melissa Kellerman 7000 Midland Blvd., Amelia, OH 45102	Phone: 513-947-6773 Fax: 513-947-4085 E-mail: MKellerman@amig.com

American Summit Insurance Company
Attention: Candice Gulliams, Senior Director of Compliance & Licensing 325 N. St Paul Street Suite 900 Dallas, TX 75201	Phone: 469-357-9342 E-mail: CGuilliams@ReAlignInsurance.com

AmGUARD Insurance Company
Attention: Bill Gray 16 S. River St., Wilkes-Barre, PA 18702-1368	Phone: 1-800-673-2465 ext. 1036 Fax: 1-570-825-0611 E-mail: bgray@guard.com

Amica Mutual Insurance Company Amica Property and Casualty Insurance Company
Attention: David Gattuso One Maynard Drive, Suite 1104, Park Ridge, NJ 07656-1878	Phone: 1-800-762-6422 Fax: 1-866-596-1095 E-mail: dgattuso@amica.com

Arch Property Casualty Insurance Company Arch Indemnity Insurance Company
Attention: Kathleen Campbell, Vice President, Compliance 210 Hudson Street, Suite 300, Jersey City, NJ 07311	Phone: 210-743-4115 Fax: 917-591-4576 E-mail: kcampbell@archinsurance.com

Ascot Insurance Company
Attention: Sherry Merber 55 W. 46th St., 26th Floor, New York, NY 10036	E-mail: Sherry.Merber@ascotgroup.com

Atlantic Mutual Insurance Company Centennial Insurance Company
Attention: Laura Ammerman PO Box 821, Madison, NJ 07940-0821	Phone: 201-408-6155

Automobile Insurance Company of Hartford, Connecticut
Attention: Lois Solecki PO Box 1900, Morristown, NJ 07962	Phone: 973-682-4930 Fax: 1-866-296-4180 E-mail: lsolecki@travelers.com

AXA Insurance Company
Attention: Jennifer Buecker 1333 Butterfield Road, Suite 5, Downers Grove, IL 60615	Phone: 321-578-5161

Balboa Insurance Company
Attention: Linda Kyd PO Box 1685, Salem, VA 24153	Phone: 1-540-375-7564 E-mail: Linda_B_Kyd@atlanticmutual.com

Bankers Standard Insurance Company
Commercial Auto Attention: Dick Snyder Wilmington Claims Center 1 Beaver Valley Road, Wilmington, DE 19803 Phone: 302-476-6007 Fax: 302-476-6513	Personal Auto Attention: Linda Kyd ACE Private Risk Services PO Box 1685, Salem, VA 24153 Phone: 1-877-210-3149 ext. 7564 Fax: 540-725-7266 E-mail: Linda.Kyd@Ace-INA.com

Benchmark Insurance Company
Attention: Mark Palmer 150 Lake Street West, Wayzata, MN 55391	Phone: 1-952-974-2216 Fax: 1-952-974-2222

Berkley Insurance Company
Attention: Kathleen A. Fitzgerald, Assistant Vice President, Regulatory Compliance Manager 475 Steamboat Road, Greenwich, CT 06830	Phone: 1-203-542-3836 Fax: 1-203-542-3839 E-mail: KathleenFitzgerald@wrberkley.com

Berkley National Insurance Company
Berkley Regional Insurance Company

Attention: Larris R. Larsen, CPCU, ACP, Vice President, Regulatory
215 Shuman Blvd., Suite 200, Naperville, IL 60563

Berkshire Hathaway Direct Insurance Company
Attention: Katrina McCusker Rusteika 100 First Stamford Place, Stamford, CT 06902	Phone: 570-606-4479 E-mail: katrina.rusteika@biberk.com

California Casualty & Fire Insurance Company
Attention: Team Manager, NJ PIP Unit PO Box 9100, Mission, KS 66201-1700	Phone: 1-800-346-6840 Fax: 1-800-230-3880

Camden Fire Insurance Association
Attention: Timothy Mulcahy 5788 Widewaters Parkway, Syracuse, NY 13214	Phone: 315-251-3088 Fax: 315-251-3004

Canal Insurance Company
Attention: Kathy Lee Williams PO Box 7, Greenville, SC 29602	Phone: 1-800-452-6911, ext. 5433 Fax: 864-679-2518 E-mail: KathyLee.Williams@canal-ins.com

CastlePoint Insurance Company
Attention: Amy Welde 440 East Swedesford Road, Wayne, PA 19087	Phone: 610-964-5294 Fax: 610-964-5251 Web site: www.genexservices.com

Greenwich Insurance Company XL Insurance America, Inc. XL Specialty Insurance Company
Attention: Anthony Hampton P.O. Box 211547, Dallas, TX 75211	Phone: 1-877-720-8844 Fax: 1-877-896-4562 E-mail: xlclaims.general.emailbox4documentum@axaxl.com

Central Mutual Insurance Company
Attention: Susan E. Sylvester PO Box 9124, Waltham, MA 02254-9124	Phone: 1-800-359-2233

Chiron Insurance Company
Attention: Amber Gilder 808 HWY 18 W, PO Box 370, Algona, IA 50511	Phone: 1-800-247-5930 ext. 7460 Fax: 515-295-4355 E-mail: amber.gilder@phmic.com

CHUBB Group of Insurance Companies
12 Vreeland Road, Florham Park, NJ 07932	Phone: 1-800-524-2392

Cincinnati Insurance Company
Attention: Optum Managed Care Services AIMS Department 2500 Monroe Blvd., Suite 100, Norristown, PA 19403	Phone: 610-631-7000 or 1-800-275-9485 Fax: 610-631-7011 E-mail: AIMSadmin@optum.com

Citizens United Reciprocal Exchange (CURE)
Attention: Marla Ongradi 214 Carnegie Center, Suite 101, Princeton, NJ 08540	Phone: 609-520-0800

Clarendon National Insurance Company
Attention: Andrea Kanakis, No-Fault Department Assistant Manager PO Box 6580, Saddle Brook, NJ 07663	Phone: 201-368-8055 Fax: 201-368-8690

Clear Spring Property and Casualty Company
Attention: Shayla Cohen PO Box 166002, Altamonte Springs, FL 32716	Phone: 321-441-1278 E-mail: mailroom@narisk.com

CM Select Insurance Company
Attention: Penny Fons 3000 Schuster Lane, Merrill, WI 54452	Phone: 1-800-200-5864 E-mail: ClaimsIntake@churchmutual.com

Commercial Hirecar Insurance Company, RRG
Attention: Harry L. Starrett, Esq. 111 Northfield Ave., Suite 305, West Orange, NJ 07052	Phone: 973-731-7127 Fax: 973-731-7025 E-mail: Starretlaw@aol.com

Continental Casualty Company Continental Insurance Company of NJ
Attention: Michael Taylor, Division Manager PO Box 907, Monmouth Junction, NJ 08852	Phone: 732-398-4120 Fax: 732-398-5015

Corepointe Insurance Company Milford Casualty Insurance Company
Commercial Auto Attention: Howard Montgomery, Director – Product Management & Filings AmTrust Financial Services, 800 Superior Ave., Cleveland, OH 44114	Phone: 1-216-525-5097 Fax: 1-800-487-9654 E-mail: Howard.Montgomery@amtrustgroup.com

Countryway Insurance Company
Attention: Paul Foley PO Box 4851, Syracuse, NY 13221	Phone: 315-634-5229 or 1-800-828-6862 Fax: 315-634-5321 E-mail: pfoley@countryway.com

CSAA Affinity Insurance Company CSAA General Insurance Company CSAA Mid-Atlantic Insurance Company of New Jersey
Attention: Casey Morris PO Box 5483, Mount Laurel, NJ 08054	Phone: 888-980-9422 Fax: 888-980-9623 E-mail: Casey.Morris@csaa.com

Darwin National Assurance Company
Attention: Karen Colonna, S.V.P. & Deputy General Counsel, U.S. Compliance 199 Water St., 24th Floor, New York, NY 10038	Phone: 646-794-0576 Fax: 646-794-0610 E-mail: Karen.Colonna@AWAC.com

Diamond State Insurance Company
Attention: David Elliott, AIC, SCLA, Assistant Vice President - Claims Three Bala Plaza East, Suite 300, Bala Cynwyd, PA 19004	Phone 1-800-788-4780, 610-538-2525 Fax: 610-660-8885 E-mail: Claims@uai-group.com E-mail: delliott@uai-group.com

Electric Insurance Company
Attention: Premier Prizm Solutions LLC 10 East Stow Road, Suite 100, Marlton, NJ 08053	Phone: 856-596-5600 Fax: 856-596-6300

EMC Property & Casualty Company EMCASCO Insurance Company Employers Mutual Casualty Company Union Insurance Company of Providence
Attention: Jim Cunningham 717 Mulberry St. Des Moines IA 50309	Phone: 515-345-7501 E-mail: Jim.R.Cunningham@EMCIns.com

Employers Insurance of Wausau Wausau Underwriters Insurance Company
Attention: Dana Campisi Metroplex Corporate Center 200 Metroplex Drive, Edison, NJ 08817	Phone: 908-777-5889 Fax: 908-777-5280

Encompass Insurance Company of NJ Encompass Property and Casualty Insurance Company of NJ
Attentionn: Mark Sessa P.O Box 1623, Winston-Salem, NC 27102	Phone: 908-842-1629 Fax: 800-924-0273 E-mail: mark.sessa@encompass-ins.com

Esurance Insurance Company of New Jersey
Attention: Rob Alessandro P.O. Box 1623, Winston-Salem, NC 27102	Phone: 336-331-6190 Fax: 800-924-0273 E-mail: robert.alessandro@ngic.com

Farm Family Casualty Insurance Company United Farm Family Insurance Company
Attention: Brandy Polak, Claim Manager PO Box 22084, Albany, NY 12201-2084	Phone: 518-431-5561 Fax: 518-391-7501 E-mail: MedicalClaimsDocuments@americannational.com

Farmers Insurance Exchange (private passenger auto)
Mid-Century Insurance Company
Farmers Insurance Exchange (commercial auto)
Truck Insurance Exchange

Attention: Farmers National Document Center
PO Box 268995, Oklahoma City, OK 73126-8995
Phone: 1-800-435-7764
Fax: 1-877-217-1389
E-mail: myclaim@farmersinsurance.com

Farmers Group P&C Insurance Company
Farmers Direct P&C Insurance Company
Farmers Property & Casualty Insurance Company
Farmers Casualty Insurance Company

Attention: Melanie Courcy
P.O. Box 6040 Scranton, PA 18505-60
Phone: 1-405-782-6944
Fax: 1-866-283-1356
E-mail: melanie.courcy@farmersinsurance.com

Federal Insurance Company Great Northern Insurance Company Pacific Indemnity Company Vigilant Insurance Company
Attention: Dana Dentzer 890 Mountain Avenue, New Providence, NJ 07974-1297	Phone: 908-771-6873

Federated Mutual Insurance Company Federated Reserve Insurance Company
Attention: Heather Goble-Sorrells PO Box 328 Owatonna, MN 55060	Phone: 317-595-4584 Fax: 1-866-636-8660 E-mail: hagoble@fedins.com

Fidelity & Guaranty Insurance Underwriters, Inc.
(See Travelers Group)

Fireman’s Fund Indemnity Corporation
Karen Wallace, PIP Supervisor One Progress Point Parkway, O'Fallon, MO 63368	Phone: 1-800-870-8857 Fax: 314-817-2686

Fitchburg Mutual Insurance Company
Attention: Sandra Duff 222 Ames Street, PO Box 9109, Dedham, MA 02027-9109	Phone: 1-800-688-1825 Fax: 866-882-0892

Foremost Insurance Company Grand Rapids, Michigan (Bristol West)
Attention: Tricia DiNunzio 400 Colonial Center Parkway, Suite 200, Lake Mary, FL 32746	Phone: 407-777-4441 Fax: 1-877-777-5766 E-mail: tricia.dinunzio@bristolwest.com

Garrison Property and Casualty Insurance Company USAA General Indemnity Company
Attention: George Strauch Claims Service Dir. Auto Injury PO Box 33490, San Antonio TX 78625	Phone: 210-498-1701 Fax: 210-498-4011 and 210-498-4012

General Casualty Company of Wisconsin
Attention: Rich Abrams 82 Hopmeadow St., Weatogue, CT 06089	Phone: 1-800-961-1121 Fax: 860-408-3268

Government Employees Insurance Co. GEICO Casualty Co. GEICO General Insurance Co. GEICO Indemnity Co. GEICO Secure Insurance Co. GEICO Choice Insurance Co.
Insight Service Group (ISG) PO Box 1247 Daphne, AL 36526	Phone: 1-877-308-6599 Fax: 866-257-2323

Granada Indemnity Company
Attention: Kirt Vovou 6676 Corporate Center Parkway, Jacksonville, FL 32216	Phone: 844-527-9489 E-mail: kvovou@granadainsurance.com

Great American Insurance Company Great American Insurance Company of NY
Attention: Kirt Vovou 500 Lanidex Center, Parsippany, NJ 07054	Phone: 201-952-9835 Fax: 201-952-9737

Greater New York Mutual Insurance Company Insurance Company of Greater New York
Attention: Joseph McGrath 377 Summerhill Road, East Brunswick, NJ 08816	Phone: 732-238-6300 ext. 276 Fax: 732-238-3781

Greenwich Insurance Company XL Insurance America, Inc. XL Specialty Insurance Company
Attention: Ashley Rohrbacher 505 Eagleview Blvd., Suite 100, Exton, PA 19341	Phone: 610-968-2896 Fax: 610-458-6653 E-mail: Karen.Trout@xlcatlin.com

Hanover Insurance Company Hanover New Jersey Insurance Company
Attention: Dawn Cottet - PIP Claims Department PO Box 15146, Worcester, MA 01615-0146	Phone: 1-800-628-0250 E-mail: dcottet@hanover.com

Hartford Group Hartford Insurance Company of the Midwest Hartford Fire Insurance Company Hartford Underwriters Insurance Company
Attention: Karen Delpome NEPLCSC PO Box 2910, Hartford, CT 06104	Phone: 1-800-280-0555 ext. 21989 Fax: 1-866-771-6001
Nutmeg Insurance Company
Attention: Georgia Graff 301 Woods Park Drive, Clinton, NY 13323	Phone: 315-385-5999 E-mail: georgiamarie.graf@thehartford.com

IFA Insurance Company
Attention: Bobbi Morin 123 North Union Avenue, Cranford, NJ 07016	Phone: 908-276-4480

Indiana Lumbermens Mutual Insurance Company
Attention: Customer Service 8888 Keystone Crossing, Suite 250, Indianapolis, IN 46240	Phone: 317-875-3607 or 1-800-732-0777 Ext. 607 Fax: 866-293-6591 Web site: www.ILMGROUP.com

Insurance Company of the State of Pennsylvania
Attention: William Murphy 100 Connell Drive, Suite 2100, Berkeley Heights, NJ 07922	Phone: 1-888-724-8881 Fax: 1-866-947-1512

Integon National Insurance Company
Nicholas Lever P.O. Box 1623, Winston-Salem, NC 27102	Phone: 216-266-0785 Fax: 800-924-0273 Email: nicholas.lever@ngic.com

Intrepid Insurance Company Intrepid Casualty Company
Attention: Scott J. Ariagno 5400 W. 110th St Paul 4th Floor Overland Park, KS 66211	Phone: 913-329-9772 Email: sariagno@intrepiddirect.com

Ironshore Indemnity Inc.
Attention: Innovative Claims Strategies, LLC Corporate Headquarters 485A Route 1 South, Suite 300, Iselin, NJ 08830	Phone: 732-404-2020 Web site: www.icstrategies.com

Key Risk Insurance Company Berkley Environmental c/o Key Risk Insurance Company
Attention: Tola Lopez -AVP Operations 303 W. Madison Street, Suite 825 Chicago, IL 60606	Phone: 1-404-443-2088 Fax: 1-404-443-2050 E-mail: tlopez@berkleysum.com

Lancer Insurance Company Lancer Insurance Company of New Jersey
Attention: Holly Ritholtz One Fairchild Court, Suite 200, Plainview, NY 11803	Phone: 1-516-349-8888 Fax: 1-516-349-9432

Liberty Mutual Insurance Group Liberty Mutual Fire Insurance Company Liberty Mutual Mid-Atlantic Insurance Company LM Insurance Corporation Wausau Underwriters Insurance Company
2501 Wilmington Road New Castle, PA 16105	Phone: 866-548-5127 Fax: 888-382-6719 E-mail: imaging@libertymutual.com
Safeco Insurance Company of America Liberty Mutual Insurance Company Peerless Indemnity Insurance Company
PO Box 1045 Marlton NJ 08053	Phone: 800-486‐6152 Fax: 866-864‐2525 E-mail: Judith.Boyce@LibertyMutual.com

Lincoln General Insurance Company
Attention: Tim Kirk, Vice President Claims PO Box 3608, 3501 Concord Road, York, PA 17402-0628	Phone: 1-800-876-3350 or 717-757-0000 Fax: 717-751-0165

Lyndon Southern Insurance Company
Attention: Howard Fishbein, SVP Specialty Claims 10751 Deerwood Park Blvd, Jacksonville, FL 32256	Phone: (904) 673-4897 E-mail: hfishbein@fortegra.com

Maidstone Insurance Company (formerly AutoOne Insurance Company)
Attention: Gina Bushee-Pacini 155 Mineola Blvd., Mineola, NY 11501	Phone: 1-866-252-4669 Fax: 1-888-741-6163 E-mail: syracusemail@autooneins.com

Markel American Insurance Company Markel Insurance Company
Attention: Kathy Kuske PO Box 906, Pewaukee, WI 53072-0906	Phone: 262-548-9880 ext. 33415 Fax: 262-548-6110 E-mail: kkuske@markelcorp.com

Maryland Casualty Company Northern Insurance Company of New Jersey
Attention: First Report Department PO Box 14013, New Brunswick, NJ 08906-4013	Phone: 908-777-5889 Fax: 908-777-5280

Merchants Mutual Insurance Company Merchants Preferred Insurance Company
Attention: James Fierro, Sr. Supervisor PO Box 78, Buffalo, NY 14240-0078	Phone: 1-800-952-5246 ext. 3147

Mercury Insurance Group Mercury Insurance Company of Illinois Mercury Indemnity Company of America
Attention: NJ PIP Team PO Box 31476, Tampa, FL 33631-3476	Phone: 1-800-987-2032 Fax: 1-866-268-8494

Meritplan Insurance Company
Attention: Linda Kyd PO Box 1685, Salem, VA 24153	Phone: 1-540-375-7564 E-mail: Linda_B_Kyd@atlanticmutual.com

Metromile Insurance Company
PIP Claims Department 1150 W. Washington St., Suite 120 Tempe, AZ 85281	Phone: 1-888-595-5485 Fax: 480-566-9659 E-mail: claimsdocuments@metromile.com

Michigan Mutual Insurance Company
Attention: James R. Kohloff 26777 Halsted Road, Farmington Hills, MI 48331-3586	Phone: 810-615-9000 Fax: 810-615-8372

National Continental Insurance Company (servicing carrier for NJ CAIP and NJ SAIP only; for non-CAIP/SAIP see Progressive Group)
Attention: Nikki Farrell 103 Morgan Lane, Suite 250, Plainsboro, NJ 08536	Phone: 1-800-444-0013 ext. 5323 or Direct Line 440-910-6328 Fax: 1-888-278-1586 E-mail: NICOLE_M_FARRELL@progressive.com

National General Group New Jersey Skylands Insurance Association MIC General Insurance Corporation
Nicholas Lever P.O. Box 1623, Winston-Salem, NC 27102	Phone: 216-266-0785 Fax: 800-924-0273 Email: nicholas.lever@ngic.com

National General Insurance Company
P.O. Box 1623, Winston-Salem, NC 27102	Phone: 216-266-0785 Fax: 800-924-0273 E mail: nicholas.lever@ngic.com

National Independent Truckers Insurance Company, RRG
Attention: Harry L. Starrett, Esq. 111 Northfield Ave., Suite 305, West Orange, NJ 07052	Phone: 973-731-7127 Fax: 973-731-7025 E-mail: Starretlaw@aol.com

National Interstate Insurance Company of Hawaii National Interstate Insurance Company
Attention: Lindsey Santana 3250 Interstate Dr., Richfield, OH 44286	Phone: 330-523-5741 Fax: 330-659-8909 E-mail: lindsey.santana@natl.com

National Liability & Fire Insurance Company
c/o Northeast Alliance Insurance Agency, LLC Attention: William Abrams PO Box 9028, Bethpage, NY 11714	Phone: 1-888-327-3000 Fax: 1-800-572-3648

Nationwide Agribusiness Insurance Company Crestbrook Insurance Company (Commercial Auto)
Attention: Claims Staff 1100 Locust St., Dept. 3010, Des Moines, IA 50391-3010	Phone: 1-800-228-6700 Fax: 1-800-842-1482 E-mail: newclaim@nationwide.com

Nationwide General Insurance Company
Attention: Claims Staff 1100 Locust St., Dept. 3010, Des Moines, IA 50391-3010	Phone: 1-800-228-6700 Fax: 1-800-842-1482 E-mail: newclaim@nationwide.com

Nationwide Group
Crestbrook Insurance Company (Private Client Auto)
Attention: Willie Wimbley, Manager-Claims 3300 Williston Road, Gainesville, FL 32608	Phone: 1-352-384-4865 E-mail: wimblew@nationwide.com

Harleysville Preferred Insurance Company Harleysville Insurance Company Harleysville Mutual Insurance Company Harleysville Insurance Company of New Jersey
Attention: Regina Cotter, Claims Manager 112 West Park Drive, Suite 200, Moorestown, NJ 08054	Phone: 1-888-595-9876 ext 2133 Fax: 1-856-642-7846 E-mail: rcotter@Harleysvillegroup.com

Harleysville Worcester Insurance Company
Attention: Daniel Roberts Jr., Claims Director PA-02-09 P.O. Box 2655 1000 Nationwide Drive, Harrisburg, PA 17105	Phone: 1-717-657-6756 Fax: 1-877-599-3898 E-mail: robertd8@nationwide.com

National Casualty Company
Attention: Troy Ulrich, Claims Manager PO Box 4120 Scottsdale, AZ 85261	Phone: 1-480-365-2850 Fax: 1-480-483-6752 E-mail: ulricht1@nationwide.com

New Hampshire Insurance Company
Attention: York Risk Services PO Box 183188, Columbus, OH 43218	Fax: 973-404-9043 E-mail: OSCeast@yorkrsg.com

New Jersey Manufacturers Insurance Company New Jersey Re-Insurance Company New Jersey Indemnity Insurance Company
Attention: Danielle Hausser PO Box 928, West Trenton, NJ 08628-0118	Phone: 609-883-1300 ext. 2532 Fax: 609-493-1277 E-mail: pipnotification@njm.com

NGM Insurance Company
Attention: Robert Casson Claims Mail Main Street America Group P O Box 19000 Jacksonville, FL 32245-9000	Phone: 315-434-1453 Fax: 1-877-705-1286 E-mail: cassonr@msagroup.com

Obsidian Insurance Company
Attention: Kaitlyn Whitney 1330 Avenue of the Americas, Suite 23A, New York, NY 10019	Phone: 860-328-0265 Fax: 732-385-3257 E-mail: kwhitney@obsidianspecialty.com

Ohio Casualty Insurance Company
Attention: Michael Galante Ohio Casualty Claim Department, PO Box 1951, Voorhees, NJ 08043	Phone: 1-866-950-5533 Fax: 1-877-343-1335

Ohio Security Insurance Company
Attention: Bruce Whitney LMAC CL PIP/Auto Med Pay Claims Cincinnati CSC PO Box 515097, Los Angeles, CA 90051-5097	Phone: 1-877-246-4264 ext. 7653730 Fax: 1-888-268-8840 E-mail: Bruce.Whitney@LibertyMutual.com

Penn Millers Insurance Company
Attention: Christine Boyle PO Box P, Wilkes-Barre, PA 18773-0016	Phone: 1-800-233-8347 Fax: 570-822-2165 E-mail: cboyle@pennmillers.com

Pennsylvania National Mutual Casualty Insurance Company Founders Insurance Company
Attention: Richard Swieconek, Claims Manager New Jersey Claims Service Office 340 Scotch Road, West Trenton, NJ 08628	Phone: 609-883-5111 ext. 5601 Fax: 609-883-8537

Personal Service Insurance Company
Attention: Soo Kim, PIP/Medical Payment Claim Manager PO Box 1930, Blue Bell, PA 19422	Phone: 1-800-727-6664 ext. 8413 Fax: 610-832-1147 E-mail: skim@good2go.com

Pharmacists Mutual Insurance Company
Attention: Joseph Alvarez 51 Haddonfield Road, Suite 350, Cherry Hill, NJ 08002	Phone: 856-532-6016 Fax: 866-450-9337 E-mail: Joseph_Alvarez@corvel.com

Plaza Insurance Company
Attention: Jay Carleton, Vice President - Casualty Claims 700 W. 47th St., Suite 350, Kansas City, MO 64112	Phone: 816-412-2829 E-mail: jcarleton@rhkc.com

Plymouth Rock Group High Point Property and Casualty Insurance Company High Point Safety and Insurance Company Palisades Insurance Company Palisades Safety and Insurance Association Teachers Auto Insurance Company of New Jersey Twin Lights Insurance Company
Attention: Lisa Wagner PO Box 900, Lincroft, NJ 07738	Phone: 1-800-258-1476 Fax: 732-978-7109 E-mail: lwagner@plymouthrock.com

Praetorian Insurance Company
Attention: Andrea Kanakis, No-Fault Department Assistant Manager PO Box 6580, Saddle Brook, NJ 07663	Phone: 201-368-8055 Fax: 201-368-8690

Preferred Professional Insurance Company
Attention: Cindy Loftis C.M.G. Agency, Inc. 10843 Old Mill Road, Omaha, NE 68154-2600	Phone: 402-551-8765 Fax: 402-392-2673 E-mail: cloftis@catholicmutual.org

Privilege Underwriters Reciprocal Exchange (PURE)
Attention: Ms. Megan Eckstrom 44 S. Broadway, White Plains, NY 10601	Phone: 508-273-8831 E-mail: MEckstrom@pureinsurance.com

ProCentury Insurance Company
Attention: Gary Forthoffer, Manager York Claims Service, Inc. 99 Cherry Hill Road, Suite 102, Parsippany, NJ 07054	Phone: 1-866-391-9675 E-mail: yorkclaimsintake@york-claims.com

Progressive Freedom Insurance Company Progressive Garden State Insurance Company Drive NJ Insurance Company National Continental Insurance Company
Attention: Gordon Dickenson 485 Route 1 South - Bldg. A, Suite 470, Iselin, NJ 08830	Phone: 732-726-5624 or 1-800-PROGRESSIVE

Public Service Mutual Insurance Company
Attention: Leslie Myrie or Michele Woodson 132 W. 31st St., New York, NY 10001	Phone: 212-560-5121 or 212-560-5116 Fax: 212-947-4019

QBE Insurance Corporation Praetorian Insurance Company North Pointe Insurance Company Stonington Insurance Company
Attention: Cindy Gawrys 210 Interstate North Parkway Suite 300,400,500, Atlanta, GA 30339	Phone: 770-850-5157 Fax: 1-866-251-5389 E-mail: cindy.gawrys@us.qbe.com

Quincy Mutual Fire Insurance Company
Attention: Deborah Marini 57 Washington St., Quincy, MA 02169	Phone: 1-800-899-1116 Fax: 1-800-899-7790

Regent Insurance Company
Attention: Rich Abrams 82 Hopmeadow St., Weatogue, CT 06089	Phone: 1-800-961-1121 Fax: 860-408-3268

Republic-Franklin Insurance Co.
Attention: Dan A. DeAngelo 104 Interchange Plaza, Cranbury, NJ 08512-9561	Phone: 609-860-6800 Fax: 609-860-6899

Response Insurance Company
Attention: Denise Warzel, PIP Supervisor 502 W. Germantown Pike, Suite 900, Plymouth Meeting, PA 19462	Phone: 610-276-3904 Fax: 610-276-3931 E-mail: dwarzel@unitrindirect.com

RLI Group RLI Insurance Company Contractors Bonding and Insurance Company
Attention: Optum Managed Care Services 2500 Monroe Blvd., Suite 100, Norristown PA 19403	Phone: 1-800-275-9485 Fax: 610-631-7011 www.procura-inc.com

Rutgers Casualty Insurance Company
Attention: Leslie Braytenbah 2250 Chapel Ave. West, Suite 200, Cherry Hill, NJ 08002	Phone: 856-779-0600

Safety National Casualty Corporation
Attention: Mitch Neuhaus, Assistant Vice President - Claims 1832 Schuetz Road, St. Louis, MO 63146	Phone: 314-692-9517 or 1-888-995-5300, ext. 29517 Fax: 314-995-3897 E-mail: mitch.neuhaus@safetynational.com

Selective Auto Insurance Co of NJ Selective Insurance Company of America Selective Way Insurance Company Selective Casualty Insurance Company Selective Fire & Casualty Insurance Company Selective Insurance Company of New England
Attention: John Guerra, Regional Claims Manager 40 Wantage Ave., Branchville, NJ 07890	Phone: 973-948-1490 Fax: 973-208-8912

Seneca Insurance Company
Attention: Frank Donahue 160 Water Street, New York, NY 10038	Phone: 212-344-3000 Fax: 212-422-7541

Sentry Casualty Company Sentry Insurance A Mutual Company Sentry Select Insurance Company (Commercial) Middlesex Insurance Company (Commercial)
Attention: Mary McCarron 1800 North Point Drive, Steven Point, WI 54481	Phone: 715-346-8351 Fax: 800-999-4642 E-mail: Mary.McCarron@sentry.com
Sentry Select Insurance Company (motorcycle) Middlesex Insurance Company (motorcycle)
Attention: Josh Smrz 1800 North Point Drive Stevens Point, WI 54481	Phone: 1-715-346-6766 Fax: 1-800-999-4642 E-mail: Josh.Smrz@sentry.com

Starnet Insurance Company

Attention: Larris R. Larsen, CPCU, ACP, Vice President, Regulatory
215 Shuman Blvd., Suite 200, Naperville, IL 60563

Starr Indemnity & Liability Company
Attention: Marina Peck, Vice President - Claims 399 Park Ave., 8th Floor, New York, NY 10022	Phone: 646-227-6586 Fax: 631-685-6732 E-mail: Marina.Peck@cvstarr.com

State Farm Indemnity Company State Farm Guaranty Insurance Company
Attention: Joseph Otis State Farm Claims, Northeastern PIP PO Box 106170, Atlanta, GA 30348-6170	Phone: 1-518-844-5380 Fax: 1-844-218-1140

State National Insurance Company
Commercial Auto Horticultural Program Attention: New Claims, NJ PIP PO Box 428, Edwardsville, IL 62025	Phone: 1-800-851-7740 Fax: 1-800-632-4445 E-mail: NewClaims@hortica-insurance.com

Sussex Insurance Company (formerly Companion Property & Casualty Insurance Company)
Attention: RIS Risk Management Services, LLC 231 Springside Drive, Suite 150, Akron, OH 44333	Phone: 1-877-758-3700 Fax: 330-685-3746

Swiss Re Corporate Solutions Elite Insurance Corporation
Attention: Cliff St. George, Compliance Officer 650 Elm St., Manchester, NH 03101	Phone: 603-644-6647 Fax: 603-644-6613 E-mail: NASGroup_Regulatory@nasins.com

Tokio Marine and NichidoFire Insurance Company Ltd. TNUS Insurance Company
Attention: Sharon Mock Yen-Ellis, Manager 230 Park Ave., New York, NY 10169	Phone: 212-297-6781 Fax: 212-297-6691

Travelers Group Fidelity & Guaranty Insurance Underwriters, Inc. St. Paul Protective Insurance Company Travelers Auto Insurance Co. of New Jersey
PO Box 430 Buffalo, NY 14240-0430	Phone: 973-682-4930 Fax: 1-866-296-4180 E-mail: NJCCCTG1@travelers.com

Trisura Insurance Company
Attention: Sarah Nichols, AINS, AIC, CSR 210 Park Avenue, Suite 1400, Oklahoma City, OK 73102	Phone: 1-405-256-1941 E-mail: sarah.nichols@trisura.com

Ullico Casualty Company
Attention: Dorothy Wallace Ullico Claims, 1625 I Street N.W., Washington, DC 20006	Phone: 202-682-7962 Fax: 202-962-8853

United Fire & Casualty Company
Attention: David Donlick P.O. Box 278, Pennington, NJ 08534	Phone: 609-737-4503 Fax: 888-514-9172 E-mail: ddonlick@unitedfiregroup.com

United Services Automobile Association USAA Casualty Insurance Company
Attention: Luis Ramirez, Claims Service Director Northeast Region Claims Department PO Box 33490, San Antonio, TX 78265	Phone: 210-498-0284 Fax: 210-498-4011 and 210-498-4012

United States Liability Insurance Company
Claims Department Attention: Emily Parker, Associate Examiner 1190 Devon Park Drive, Wayne, PA 19087	Phone: 1-800-523-5545 ext. 2440 Fax: 1-610-687-9398 E-mail: eparker@usli.com or newlosses@usli.com

Unitrin Direct Insurance Company
Attention: Cheri Martinozzi 502 West Germantown Pike, Suite 900, Plymouth Meeting, PA 19462	Phone: 1-877-270-5702 Fax: 610-276-3931

Universal Underwriters Insurance Company
Attention: Regional Claims Manager - Suite 206 100 Walnut Avenue, Clark, NJ 07066	Phone: 908-396-8500 Fax: 908-396-8509

Utica Mutual Insurance Co. Graphic Arts Mutual Insurance Co.
Attention: Dan A. DeAngelo 104 Interchange Plaza, Cranbury, NJ 08512-9561	Phone: 609-860-6800 Fax: 609-860-6899
Utica National Insurance Company of Texas Utica National Assurance Company
Attention: Louisa Ruffine, Associate General Counsel Utica National Insurance 180 Genesee Street, New Hartford, NY 13413	Phone: (800) 598-8422 Ext. 7342686 E-mail: louisa.ruffine@uticanational.com

Valley Forge Insurance Company
Attention: Michael Taylor, Division Manager PO Box 2113, Cranbury, NJ 08570	Phone: 609-395-2465 Fax: 609-395-6678

Vault Reciprocal Exchange
Attention: Peter Piotrowski 300 1st Avenue S, Suite 401 St. Petersburg, FL 33701	Phone: 1-727-440-3551 Fax: 1-718-744-2099 E-mail: Peter.Piotrowski@Vault.Insurance

West American Insurance Company
Attention: Michael Galante Ohio Casualty Claim Department PO Box 1951, Voorhees, NJ 08043	Phone: 1-866-950-5533 Fax: 1-877-343-1335

Watford Insurance Company
Attention: John R. Wilkens, CPCU Harborside 3, 210 Hudson St., Suite 300 Jersey City, NJ 07311	Phone: 201-743-3935 E-mail: jwilkens@archinsurance.com

WRM America Indemnity Company, Inc.
Attention: Linda Eori, Manager 600 Unicorn Park, Woburn, MA 01801	Phone: 781-396-6288 Fax: 781-395-5592 E-mail: leori@bmegateway.com



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