Claim Reporting
General
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Digital Claim Reporting Demo
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Digital Member User Account Set Up
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First Pharmacy Visit form
Auto Loss and General Liability forms
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Auto Loss Notice Fill-in
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Auto Loss Notice Standard
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General Liability Notice Fill-in
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General Liability Notice Standard
Once the form is complete, please
e-mail the completed form to:
Karen Berenato
Phone: 609-653-8400 x2302
Fax: 609-601-3173
kberenato@qual-lynx.com
Property Loss Forms
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Property Loss Notice Fill-in
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Property Loss Notice Standard
Workers' Compensation Forms
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Employee Accident Report
(Both reports must be completed and submitted after an injury is called in)
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Supervisor Report
(Both reports must be completed and submitted after an injury is called in)
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NJPHA Workers' Compensation Injury Reporting Procedure
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Workers' Compensation Injury Poster
Our goal is to provide uninterrupted service to our valued
clients!
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Emergency Claim Reporting Procedures
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Qual-Lynx account service team