Friday, April 10, 2015

Certification of Insurance Coverage

DISCLAIMER  The comments on this blog are the opinions of the blogger based on personal experience as a defendant in a divorce case.  Please note that the information here does not constitute legal advice.  I am not a lawyer.  It is strongly recommended that you hire a family law attorney, licensed to practice in your state, to represent you and to help guide you through the complicated process of divorce.


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Just as you might expect, you submit a Certification of Insurance Coverage to certify that you have insurance and to give information about all of your insurance policies.  

I was instructed to use Form 2 - Certification of Insurance, which is found in Divorce in New Jersey: A Self-Help Guide, that helpful book published by Legal Services of New Jersey.  I photocopied the form, crossed out the word plaintiff, and wrote in defendant.  

The form had four sections:

      • Automobile Insurance
      • Health Insurance
      • Homeowners Insurance
      • Life Insurance

LSNJ doesn't make this form available online, either.  I found the Self-Help Guide in the courthouse law library.

To date, I haven't been able to locate a Certification of Insurance Coverage form on the NJ State Judiciary website, although I've noticed that several attorneys offer free downloads of their own forms on their websites.

However, I did find another Certification of Insurance Coverage form in a book at my local public library.  The book is called File for Divorce in New Jersey, and it's published by Sphinx Publishing.  

Anyway, I've noticed that everyone's Certification of Insurance Coverage statement follows the same format in accordance with NJ Rule 5:4-2(f).  Each and every prewritten form essentially contains the following lines:


  1. I am the defendant (or the plaintiff).
  2. At present, the following insurance policies represent all of the insurance coverage obtained by or for myself.
  3. To the best of my knowledge and belief, none of this insurance coverage has been canceled or modified within the past 90 days.

On my form, I listed information about every policy, including the company name, policy number, and the name(s) of the insured.  Any other relevant information, such as a life insurance beneficiary, needed to be listed, too.

Finally, every Certification of Insurance Coverage ends with this standard clause:

I certify that the foregoing statements made by me are true.  I am aware that if any of the foregoing statements made by me are willfully false, I am subject to punishment.

And, of course, the litigant's signature and the date is required at the bottom.

Remember, I'm merely sharing my observations on this blog.  As always, check with a lawyer and/or the courthouse for more information before filing any paper. 






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