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GENERAL LIABILITY
The JIF will pay for bodily injury and property damage liability claims arising out of
municipal activities in accordance with the coverage described in the Plan of Risk
Management and Coverage Documents provided by the Fund.
Types of losses to be reported on this form:
Trip/slip--falls (anywhere).
Highway accidents not involving an insured vehicle (i.e., pothole
claims, motor vehicle accidents due to weather or alleged road
conditions).
Improper signage/obstruction of view allegations.
Police liability, false arrest, assault, etc.
Police liability due to bodily injury or property damage allegedly
caused by police activities.
Sewer back-ups which cause damage to other than municipal owned
property.
The purpose of this manual is to highlight the major coverages, limits, sub-limits, and
extensions as afforded through the Joint Insurance Fund. This manual is not a policy of
insurance and in no way modifies, restricts, expands or in any way changes the
coverages afforded through the JIF. For actual coverage determination, reference must
be made to applicable coverage documents.
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GENERAL LIABILITY – Reporting Instructions
GENERAL LIABILITY REPORTING INSTRUCTIONS
(INCLUDING POLICE PROFESSIONAL LIABILITY)
1. You will receive some type of notice of claim from either the claimant or
his/her attorney. In some instances, the injured party will report the claim by
telephone, which obviously will not contain sufficient information to meet
New Jersey State Statute (See Section 9, Tort Claims Notice Procedures).
However, you may take the information from the injured party and utilize the
ACORD General Liability Loss Notice (sample attached) in reporting the
claim to our office. Although the ACORD General Liability Loss Notice
does not contain a sufficient amount of information to adhere to New Jersey
Statute, we will obtain additional information once we have received the
claim from you. The information, however, should contain the following:
A. Name of injured party or party by whom damages are claimed.
B. Address and telephone number of above party.
C. Social Security Number, if possible.
D. Date, time, and place of accident.
E. Brief facts about the accident.
F. Extent of injuries.
2. Once you have obtained the above information, please complete the Claim
Transmittal Form (sample attached). You will note that the Transmittal Form
includes information as to the type of claim, which department was involved,
the name of the claimant, the date of loss and the date you are transmitting the
information to us. Also indicate whether this is a new claim or additional
information on an existing claim being forwarded to us.
3. Once we have received this information, we will assign an adjuster and an
Acknowledgment Letter will be sent back to you. The Acknowledgment will
identify the adjuster assigned and our claim number, which you will use when
transmitting additional documents or information to us (see attached sample).
4. It is important that you forward any official reports that your police, fire or
other departments may have completed with reference to the incident. Do
not hold up the claim until the official reports are completed by the individual
department, but forward them to us once they are completed and received in
your office.
Refer all correspondence, telephone calls and inquires from claimants and their attorneys
to a Scibal Associates claims adjuster for handling.
GENERAL LIABILITY – Helpful Hints
HELPFUL HINTS
These are some helpful hints that will assist you in processing your General Liability
claims.
Be sure to keep a copy of all information sent to Scibal.
If attorney letter is first notice of claim you receive follow the
Tort Claims Notice Procedures in Section IX . Then fill in the
ACORD form with as much information as you know about the
loss. Attach a copy of the attorney letter to the ACORD Notice
and immediately fax or mail to Scibal.
GENERAL LIABILITY – Common Errors
COMMON ERRORS
These are some common errors made when reporting General Liability losses.
No date of loss on the forms.
Using the wrong form.
Leaving blank the information on the contact person or putting
the incorrect person's name in that blank.
No description of the loss.
Leaving the address and phone number of the claimant blank.
Leaving the injuries or damage information blank.
GENERAL LIABILITY – Sample Claim Transmittal Form
CLAIM TRANSMITTAL FORM
TO: Scibal Associates, Inc.
P.O. Box 500
Somers Point, NJ 08244-0500
PHONE: 609-653-8400
FAX: 609-926-9270
FROM: Claims Coordinator
Borough of Sunnytowne
PHONE: 609-555-1234
FAX: 609-555-5678
TODAY’S DATE: 6/30/02
This is a: New Claim
Additional Information on Existing Claim
Claim Number, if known
Date of Loss: 6/22/02
Claimant Name: Borough of Sunnytowne
Claim Type: Auto Liability Auto Physical Damage
General Liability Property
Workers’ Compensation
Department: NCCI Code:
Street Maintenance 5509
Water Department 7520
Electric Department 7539
Sewage Disposal 7580
Paid Fire Department 7711
Paid First Sid/Rescue Squad 7715
Police 7720
Crossing Guards 7727
Off Duty Police 7728
Clerical 8810
Library 8838
Buildings Department 9015
Lifeguards 9053
Parks Department 9102
Street Cleaning 9402
Garbage Collection 9403
Municipal Employees NOC 9410
Volunteer First Aid/Rescue Squad 9420
Volunteer Firefighter 9430
Always complete this form whenever transmitting claim information to Scibal Associates
GENERAL LIABILITY – Sample Claim Transmittal Form
CLAIM TRANSMITTAL FORM
TO: Scibal Associates, Inc.
P.O. Box 500
Somers Point, NJ 08244-0500
PHONE: 609-653-8400
FAX: 609-926-9270
FROM: Claims Coordinator
Borough of Sunnytowne
PHONE: 609-555-1234
FAX: 609-555-5678
TODAY’S DATE: 8/3/02
This is a: New Claim
Additional Information on Existing Claim
Claim Number, if known
Date of Loss: 7/1/02
Claimant Name: Borough of Sunnytowne
Claim Type: Auto Liability Auto Physical Damage
General Liability Property
Workers’ Compensation
Department: NCCI Code:
Street Maintenance 5509
Water Department 7520
Electric Department 7539
Sewage Disposal 7580
Paid Fire Department 7711
Paid First Sid/Rescue Squad 7715
Police 7720
Crossing Guards 7727
Off Duty Police 7728
Clerical 8810
Library 8838
Buildings Department 9015
Lifeguards 9053
Parks Department 9102
Street Cleaning 9402
Garbage Collection 9403
Municipal Employees NOC 9410
Volunteer First Aid/Rescue Squad 9420
Volunteer Firefighter 9430
Always complete this form whenever transmitting claim information to Scibal Associates
GENERAL LIABILITY
JOHN J. JUSTICE, JR.
COUNSELOR AT LAW
A PROFESSIONAL CORPORATION
666 COUTHOUSE ROW
SUNNYTOWNE, NJ 08000
TELEPHONE: (609) 555-1234
FACSIMILE: (609 555-4321
July 30, 2002
Borough of Sunnytowne Certified - Return Receipt Requested
123 State Street
Sunnytowne, NJ 08000
Attention: Borough Clerk
Re: Betty Smith v. Borough of Sunnytowne
Date of Loss: July 1, 2002
Place of Accident: Sunnytowne Borough - Municipal Boardwalk
Dear Sir/Madame:
Please be advised that as a result of the above stated accident, my client has suffered
damages. These damages arise as a result of negligent maintenance of the Municipal
Boardwalk.
Kindly forward this letter to your liability insurance carriers and have them contact me
immediately. If you are not insured, you or your attorney should contact this office
regarding resolution of this matter.
Very truly yours,
John J. Justice, Jr.
JJJ/dew
GENERAL LIABILITY
HIGHWAY ACCIDENT INVESTIGATIONS
Even the best designed roads cannot prevent all accidents. Human error inevitably leads
to accidents, especially when automobile traffic is concerned. Your municipality should
have an established protocol when a serious automobile accident takes place on roadways
and streets for which you are responsible. A separate standard accident investigation
protocol should be used when the accident involves one of your vehicles.
This accident investigation protocol should include the following for any automobile
accident involving an intersectional collision or serious injuries:
Have a police accident investigator take pictures not just of the accident scene,
but wide-angle pictures of the approaches to the intersection, from a minimum
of a block away from each direction. Try to show in the picture what the
drivers saw as they approached.
If available to your community, use a hi-lift or cherry picker to take bird’s eye
views of complex intersections or accident scenes.
Have a checklist for the police investigator to follow in taking the pictures. All
pictures should be taken within the context of the scene, at the time of the
accident. Conditions of guardrails, cycles of the traffic signals, lines of sight,
condition of signage and landscaping features should be on the checklist.
Identify all witnesses and obtain detailed statements as soon as possible. If any
witness indicates that a road defect was involved, secure your own records on
such items as traffic counts, traffic surveys, trouble calls, repair orders and
other internal information that will help establish the true condition of the road
at the time of the accident.
Notify your claim or insurance investigator as soon as possible if any accident
caused death, head injuries, loss of use of any limb or bodily function or other
serious bodily injury.
Develop a way to maintain your records accurately for an appropriate period.
New Jersey has guidelines dictating how long you must maintain records.
Review these guidelines with your legal counsel to ensure that your record-
keeping procedures are adequate. Any records that are, or might be, involved
in litigation should be maintained until the case has exhausted all of its appeals.
Cases involving minors should be held until the minors reach their age of
majority (18), plus the statute of limitations period (2 years) once they reach
their age of majority.
GENERAL LIABILITY – Accident Investigations
INCIDENT INVESTIGATIONS
(Other than Workers Compensation)
Accidents don’t just happen; they are caused. After incidents or accidents involving
employees, injuries or property damage, someone in authority should investigate to
determine what happened. All accidents, including those occurring to volunteers or
citizens, should be investigated by the supervisor responsible for the area in which
the incident occurred. “Near misses” are accidents also, and even if they do not
cause injury or damage, they should be investigated as thoroughly as an accident
that results in injury or property damage. We have developed a Supervisor’s
Incident Investigation Report form that you can use to investigate accidents. Attach
a copy to your Scibal claims transmittal and forward copies to your Safety
Coordinator and the JIF Safety Director (Commerce National Risk Control
Services). The Incident Investigation Report can be reproduced in your office or
additional supplies can be ordered from the Fund Administrator, the Fund Safety
Director, or the Claims Administrator.
Remember: The purpose of investigating accidents is not to
determine who was at fault, but to determine the cause so that
similar accidents can be prevented in the future.
When an employee is involved in an accident or causes any damage, the supervisor
or someone in authority should make a detailed report about the incident and should
document what happened. Too often, supervisors and managers focus on a
symptom of the problem, such as frequent accidents or employee injuries, when the
actual problem may be a failure to perform proper inspections for hazards, supervise
employees, provide proper instructions and training, or enforce work rules.
Investigations provide:
Documentation that can be used in analyzing whether claims are justified.
GENERAL LIABILITY – Accident Investigations
A basis for understanding what causes an incident--whether or not
a loss occurred.
Clues to determine what the actual problem is.
Formation of actions that can be take to address the problem.
Information on incidents and losses that help identify trends and
potential losses.
After acquiring necessary medical aid for injured persons, supervisors should follow
these steps for investigating accidents:
If possible, ask the person or persons involved to describe what happened.
Do not fix blame or find fault; just get the facts.
Survey the accident scene for information. Collect any objects that might
have contributed to the accident.
Determine if there were any witnesses to the accident and get their accounts
of the incident.
Take whatever steps are necessary to prevent recurrences until the condition
can be permanently corrected.
Complete an Incident Investigation Form.
If the police were called, attach a copy of the police report to the Incident
Investigation Form. This is most common for vehicle accidents.
Most accidents occur because of a combination of an unsafe act and an unsafe
physical condition. Look for both, and then draw a conclusion as to why the unsafe
act was committed or why the condition existed.
Once an accident occurs, immediate action must be taken to prevent a recurrence.
Indicate what needs to be done and who is going to do it.
