Plymouth Rock Claims FAQs

Plymouth Rock Claims FAQs

If you need to report a claim, please click here.
If you have additional questions regarding your claim, please contact your claim representative directly. If you don’t know their name, contact us and we'll connect you to them.


If you are a policyholder and need to report a claim, please click here to report your claim online. If you are not a policyholder or you prefer to report your claim by phone, call.

If you are a New York policyholder, or were involved in an accident with a New York policyholder, and wish to report your claim by phone, call 844-208-1933.

When contacting Plymouth Rock about a claim, please be ready to provide your name and address, names and addresses of any witnesses or injured parties, general loss information, and your Plymouth Rock policy number (if available). If you don’t have all of this information, do not wait to report the loss. Please report the claim with the information you have. The claim can be updated later once the information becomes available.

A police report is helpful in assisting with the reporting of a loss, but it is not mandatory. However, you may be required by law to report your accident to authorities. An accident can be reported with minimal information and a police report can be obtained later in the process.

Are you a New York driver? New York State Vehicle and Traffic Law mandates that all involved drivers are required to file a Report of Motor Vehicle Accident (MV-104) with the DMV no more than 10 days after the accident if the accident involves $1,001 or more in property damage to any one person is injured or killed.

If you are ever in an accident, follow these simple steps:

  1. Make sure that everyone is safe and that medical/emergency care is being provided.
  2. Notify the local police.
  3. Write down the following information: location, date, and time.
  4. Names, addresses, and license numbers of other drivers and passengers (if possible).
  5. License plate numbers and vehicle descriptions.
  6. Injuries to you and others, if any.
  7. Names and telephone numbers of any witnesses.
  8. If you have the ability to take photos of the accident scene, please do so and submit them to us when you report the claim.
  9. Report your accident to us immediately by clicking here or visit Contact Us to find the claims telephone number for the location nearest you. Representatives are here to serve you 24/7. If you wish, you may also contact your agent.

Auto Claims

As a Plymouth Rock Assurance customer, you can select any repair shop you like to fix your vehicle.  Some states require a repair shop to be licensed or registered – your claim representative will be able to provide you with this information. To find a repair shop near you, visit our Repair Shop Finder.  In states where we have a referral shop program, if you select one of our referral shops, you will be entitled to the following:

The only out-of-pocket expense you will pay to repair the covered damage is your deductible. We guarantee the work fully for as long as you own or lease your car. Of course, you are free to select a registered auto repair shop that is not one of our referral shops. However, in that case, we will not guarantee the repairs.

If you are a New York policyholder, and need assistance locating a repair shop, please contact your claim representative. Please note that these are not Plymouth Rock referral shops and Plymouth Rock does not guarantee the repairs.

If you purchased rental reimbursement coverage (also known as substitute transportation coverage), we’ll help you arrange for a rental car while your vehicle is being repaired.

Even if you don’t have this coverage, we’ll still be happy to arrange a rental delivery (the rental will be billed directly to you). Just contact your Plymouth Rock Claims representative. Visit Contact Us to find the correct Claims number for your location.

Once you report a loss to Plymouth Rock, we will assign an auto damage appraiser to inspect your vehicle at a convenient location of your choosing – your home, your office, or to wherever your car was towed — to appraise the damage.

Towing and Labor coverage is an optional coverage that is available for purchase. If you have purchased Towing and Labor coverage and your vehicle is disabled due to a mechanical problem, you can have it towed to a repair shop. We’ll pick up the towing cost up to the amount of coverage you selected. Visit Contact Us to find the claims number for your location to set up a claim for reimbursement.

In some states, we offer Door to Door Valet Claim Service. With Door to Door, getting your car fixed when you have a covered loss couldn’t be easier. It’s almost like having a personal valet. Just contact your assigned Claims Representative or visit Contact Us to find the claims number for your location. You won’t have to leave your home or office, visit a repair shop, or find a rental car. It’s our way of making the repair process as stress-free as possible.

If you choose to use Door to Door for your covered loss, we will provide you with a list of nearby Door-to-Door auto repair shops. We’ll pick up your damaged car or truck and have it towed to the shop you select. If you have rental reimbursement coverage, we’ll arrange to have a rental vehicle delivered to you. Even if you don’t have this coverage, we’ll still be happy to arrange a rental vehicle delivery. The rental will be billed directly to you.

Finally, when your car or truck is repaired, we’ll deliver it to your home or office, pick up the rental vehicle, and return it for you.

A chipped, cracked, or broken windshield or window is potentially dangerous, and should be repaired or replaced right away.

If you purchased comprehensive coverage, Plymouth Rock’s GLASSCARE® program will repair or replace any glass damage to your car. You can submit a claim online here.  We’ll help you schedule an appointment at a high-quality glass shop or arrange to have a mobile repair van come to you.

Home Claims

Once you’re sure everyone is safe, please take these steps:

  • Report your claim promptly
  • Take photos and/or video of the damage
  • Protect your property to prevent further damage. Call your Claims Representative for help with emergency services like water removal and roof board-up.
  • Save receipts for the expenses you incur protecting your property
  • In the event of theft, report the loss to the police

Your claim will be assigned to a Plymouth Rock Claims Representative, who will carefully review your policy. They’ll explain the claims process to you and let you know if your claim is covered by your policy.

If possible, we’ll complete a review of your home and personal items over the phone or via video chat. In some instances, a Claims Representative may need to visit your home to complete a thorough damage inspection.

Your policy has a deductible, but the amount can vary depending on your policy and the type of loss. Your Claims Representative will determine what deductible applies and its amount. Your deductible is the amount you pay out-of-pocket toward repair or replacement costs, which, in most cases, you’ll pay directly to your contractor.

You should not begin repairs or replace any items until your Claims Representative inspects the damages. Your Claims Rep will help you determine when repairs or replacement is appropriate. NOTE: If your home requires emergency services (water removal, roof or window board-up, etc.) to prevent further damages, you need do that first.

New Jersey Personal Injury Protection(PIP)

Your medical bills should be sent to:
Plymouth Rock Assurance
PO Box 900
Lincroft, NJ 07738-0900

For your convenience, a self-addressed envelope will be provided in your initial PIP Package. Please put your claim number on the envelope and on the medical bills themselves so that we can promptly direct your bills to your claims representative.

If you have chosen your health carrier as primary, please be sure to submit all medical bills to your health insurer first. If there are any outstanding balances remaining after your health carrier has processed your bills as primary, please send us a copy of their Explanation of Benefits (EOB) along with a copy of the corresponding bill(s). You may also fax your medical bills to 732-978-7109. If you are sending your bills by fax please be sure to write your claim number on a cover sheet or on the bill itself to ensure that the bill is directed to the correct claims representative.

It is important to report any accident to us as soon as possible. There are several ways you can report your claim. Our First Report Unit can be reached toll-free 24/7 at 800-437-3535. You can also report your claim online. If you have an agent, you may ask that he or she report the claim for you.

Failure to comply with prompt notice may result in a reduction of reimbursement (co-payment penalty) of eligible charges for medically necessary expenses that are incurred after notification to us is required and until notification is received. This requirement applies at all times unless the eligible injured person submits written proof providing clear and reasonable justification for the failure to comply with such time limitations.

Reporting Timeframe
Loss reported 31-60 days after accident
Loss reported 61 or more days after accident

Copayment Penalty
25% Penalty
50% Penalty

The Statute of Limitations on PIP claims in the State of New Jersey requires that an action for benefits be filed not later than two years after the injured person suffers a loss or incurs an expense caused by the accident, or not later than four years after the accident, whichever is earlier, provided that if benefits have been paid before then, an action for further benefits may be commenced not later than two years after the last payment of benefits.

The State of New Jersey enacted regulations to ensure that you receive the appropriate level of quality care for your injuries. For this reason, we encourage your health care provider to contact us and agree to a comprehensive treatment plan, including any medications prescribed. If precertification is required and not obtained, we may impose a penalty against the provider on services that are medically necessary, but not precertified. Your provider is not permitted to bill you for the amount of the penalty.

These requirements apply at all times, except when the medically necessary treatments or care, medical services and medical transportation are provided within the first ten days following the covered accident or when administered during emergency care.

For a complete copy of our Precertification and Decision Point Review Plan, click here.

A PIP Claims Representative will contact you to discuss your injuries and also to get the names of any health care providers you may be seeing. It is important that we have this information so that we can maintain contact with your providers regarding your treatment. In order for us to process your claim, you must complete the Application for Benefits – Personal Injury Protection form, which we will send to you, along with a copy of this notice, when you report a claim involving personal injury. You may also find a copy of the Application for Benefits here.

It is also a good idea for you to share this information with all of your health care providers, as they will be responsible for adhering to the Decision Point Review and Precertification requirements and regulations. Each provider will be responsible for submitting the Notification of the Commencement of Treatment form, which is also sent to you when you report a claim involving personal injury.

A person seeking any coverage must:

  • Cooperate with us in the investigation of any accident or loss.
  • As soon as reasonably practicable, give or send us copies of any notices or legal papers sent or received in connection with the accident or loss.
  • Submit as often as we require, to physical and mental exams by physicians we select.
  • Submit to exams under oath as often as we reasonable request and must take place within 30 days of our request.
  • Provide us, as we reasonably request with signed statements and recorded statement.

A higher benefit of coverage is available in-network. Because our payments to an in-network provider are generally less than those paid to an out of network provider, your medical expense benefits are depleted at a slower rate. In addition, failure to schedule the appointment through the Voluntary Network or to utilize the Voluntary Diagnostic Network will result in an additional 30% copayment of the eligible charges that are incurred for medically necessary tests, equipment, and procedures listed below.

Eligible injured persons will be referred to our approved Voluntary Networks for specific diagnostic testing, durable medical equipment, and outpatient services. You can find a list of participating doctors and facilities through our Signature Medical Concierge Program.

PIP is your medical coverage for injuries you sustain in an auto accident. PIP is sometimes called “no-fault” coverage because it pays your own medical expenses regardless of who caused the accident. PIP has two parts:

Coverage for the cost of treatment you receive from hospitals, doctors, and other medical providers, and any medical equipment that may be needed to treat your injuries.

Depending on the coverage that was selected, reimbursement for other expenses you may have, such as income continuation or essential services.

In the State of NJ, regardless of fault, each injured person must go back to their own auto insurance policy for medical coverage. For example, if you are injured in an accident that is not your fault, your medical bills are still handled by your own insurance company, not by the insurance company of the at-fault driver. Even if you are injured in someone else’s car, your own auto insurance would be responsible for paying your medical bills.

When you treat with a New Jersey medical provider, you are not required to pay any charges that are in excess of the New Jersey Fee Schedule. No health care provider may demand or request any payment from any person in excess of those permitted by the Fee Schedule (N.J.A.C. 11:3-29), and no person is liable to any health care provider for any amount of money which results from the charging of fees in excess of that fee schedule (N.J.A.C. 11:3-29 pursuant to N.J.S.A. 39:6A-4.6).

You are, however, responsible for any unpaid amounts due to the application of the deductible and/or copayment. If you receive a bill from a health care provider for a balance due (with the exception of the amounts applied toward your deductible/copayment), contact your Claims Representative.

New Jersey law states that all insurance carriers have 60 days (calculated from the date the bill is received) to process your medical bills. However, if for any reason Plymouth Rock requires additional information prior to making a payment decision, we may request an extension not to exceed an additional 45 days (105 days total). If we require additional information from you prior to making a payment decision, you will be contacted by your Claims Representative by phone and/or by mail. If we require additional information from your medical provider, we will request that required information in writing.

If you receive a statement in the mail from Plymouth Rock related to your PIP claim, it is called an Explanation of Benefits (EOB). You will receive an EOB from Plymouth Rock every time we process a medical bill related to your claim. The EOB contains important information about that particular bill, including the name of the medical provider, the amount that they billed, and the procedures they performed.

It is very important to review the EOB for accuracy. If your EOB shows that a medical provider has billed for any service(s) that were not provided, please notify your Claims Representative immediately.

The EOB will also show what Plymouth Rock paid to that medical provider and any amounts applied toward your deductible and/or copayments that you may be responsible for. In some cases, if someone else was at fault for the accident, you may be able to recover your out-of-pocket expenses from their insurance company.

In 1988, the State of New Jersey introduced mandatory PIP deductibles and copayments. These provisions apply regardless of who is at fault for the accident. This is why PIP coverage is sometimes referred to as “no-fault” coverage. Any unpaid amounts due to the application of the deductible and/or copayment can be submitted to your health carrier for consideration, along with a copy of the Explanation of Benefits (EOB). The EOB outlines the amount the provider charged, the amount allowed under the NJ Fee Schedule, the application of the deductible/copayment, and the amount Plymouth Rock paid.

The deductible you selected will determine your total out-of-pocket expense. Remember, you can submit these expenses to your health carrier for consideration. If someone else was at fault for the accident, you may be able to recover your out-of-pocket expenses from their insurance company. Click here to view Statutory Deductibles and Copayments.

Due to the Federal Reporting requirements under the Medicare Secondary Payor Act, Plymouth Rock needs to secure Social Security Numbers for each injured person to fulfill this Federal Reporting Requirement. We cannot process any PIP claims without first reporting your Social Security Number to meet the federal requirements.

New Jersey Health Care Primary

  • Lower your Personal Injury Protection (PIP) premium.
  • Utilize providers who already know your medical history and have your overall care in mind.
  • Follow the same health care processes and procedures already familiar to you.
  • Depending on the terms of your health carrier plan, you may have less out-of-pocket expenses. PIP deductibles range from $250 to $2,500 with a 20% copayment for the first $5,000 in medical expenses, per accident.

If your plan does not cover treatment(s) rendered by a particular specialist, your PIP coverage will provide primary benefits for those services. Your health insurance carrier will remain primary for all other care.  Please note that the treatment received must be medically necessary and related to the accident in order for it to be covered under your PIP (Personal Injury Protection) coverage with Plymouth Rock.

If you choose to treat with a provider that does not participate in your health care plan, your PIP coverage will provide primary benefits for that provider only.  Your health insurance carrier will remain primary for all other care. Please note that the treatment received from the non-participating provider must be medically necessary and related to the accident in order for it to be covered under your PIP (Personal Injury Protection) coverage with Plymouth Rock.

You will not be left without coverage if you are injured in an automobile accident. NJ law dictates that if your health insurance policy excludes injuries from automobile accidents, your automobile carrier is required to provide PIP benefits as primary.  However, any treatment received must be medically necessary and related to the accident in order for it to be covered under your PIP (Personal Injury Protection) coverage with Plymouth Rock.

If you have health coverage (other than plans governed by Medicaid or Medicare, or a or a New Jersey Family Care Plan — provided by Aetna Better Health, AmeriGroup Community Care, Horizon NJ Health, UnitedHealthcare Community Plan or WellCare), you may select this option.

Individuals who are 65 years of age or older and are eligible for Medicare or Medicaid, or those with a New Jersey Family Care Plan (provided by Aetna Better Health, AmeriGroup Community Care, Horizon NJ Health, UnitedHealthcare Community Plan or WellCare) are not eligible to elect Health Care Primary.