The Northern Illinois Conference’s Property and Casualty program includes; providing claim advocacy for Property, Liability and Workers’ Compensation losses, calculation of the annual insurance allocation/premium and development of a safe environment for Conference churches, volunteers and visitors.



Dwayne Jackson

Dwayne Jackson, Director of Risk Management and Ministry Protection


Phone: 312.783.5945

2017 Insurance Summary & Claim Reporting Instructions

The 2017 Insurance Summary & Claim Reporting Instructions serve as a resource for understanding the Conference’s Master Insurance Program.  The information contained therein outlies the various lines of coverages, deductibles and insurance limits that apply to each respective church, camp & ministry.  

Note, effective January 1, 2017, all claims shall be reported by the church, camp or ministry directly to the insurance company listed.

Insurance Deductibles

Refer to the attached for a “Recap” of the insurance deductibles and the policy limits by line of coverage.

Certificate of Insurance Request Form

Please complete the Certificate of Request Form and forward to Dwayne Jackson, Risk Manager, at  The requested Certificate will be issued within forty-eight (48) hours of receiving the request, Monday – Friday.

Sample Insurance Claim Forms 

In preparation of reporting a loss to the insurance carrier the following sample insurance claim forms may be used as a guide to assemble information requested by the insurance carrier.

Add/Delete Vehicle or Building

Please complete the Add/Delete Form in order to Add/Delete a vehicle or building.

Fax Cover Pages

Please complete the attached Fax Cover Page to submit information/documents to the Philadelphia Insurance Company (e.g. General Liability or Auto) or to Travelers Insurance (e.g. Property).


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