This form should be filled out in as much detail as possible to assist the CBJ in evaluating your claim. Depending on the type of claim, we will either evaluate the claim in-house or forward to our adjusting company for review and investigation. How long it will take to adjust the claim and finalize a decision will depend on the complexity and nature of the accident/incident.
Jennifer Mannix, Risk Management Officer
Human Resources/Risk Management Department email@example.com
(907) 586-0323 phone
(907) 586-4502 fax