Truckers Occupational Accident Insurance Enrollment Process
It's As Easy as 1,2,3
Fill out and submit form to start the application process.
Occ Acc insurance currently, not available in DC, MA, NV, NY, VT, MD, NJ
Manual Enrollment Process Below
Step One - Download Description and Sign.
Step Two - Pick Plan A or Plan B - Download PDF to your computer & return completed, signed form.
Step Three -
Download, Print and Return One NTA Member Registration per Driver, Electronic Authorization Form, Loss History Affidavit from and include a copy of your Lease Agreement
Email all forms to firstname.lastname@example.org or Print and Fax everything to 800-810-6998. This goes to my computer. - Wayne Schooling
This is a medical reimbursement group policy. This is NOT Workers’ Compensation Insurance. Each Independent Contractor is required to have his business join the Association thusly upholding his/her independent contractor status. It is mandatory that the Independent Contractor business be a participant in the Master Group. The cost for this is $100.00 per year. Every Independent Contractor can have his/her own policy.
Therefore, you must add $100.00 to whichever plan you choose for the 1st month only. Thereafter, you will only pay the monthly fee (Plan A $145.00 or Plan B $124) plus a small
administration fee ($5.00).
This is a month-to-month policy. Please be advised that you MUST make sure that your Monthly Premium arrives by the 15th day of the month preceding the month for which the premium is being reported. In other words, the premium must be received by NTA Administrative Services two weeks BEFORE the 1st of the month. This allows us plenty of time for processing your policy and forwarding the premiums to the insurance company.
Make your check payable to NTA Administrative Services (which is a separate
company from NorthAmerican Transportation Association Inc) and remit to:
NTA Administrative Services
2525 Cherry Ave, Suite 368
Signal Hill, CA 90755
Fax: 562-279-0566 or 800-810-6998
To add someone, fill out the application in full and mail in with the applicable fees to NTA Admin Services, 2525 Cherry Ave, Ste 368, Signal Hill, CA 90755. Fax: 562-279-0566 or 800-810-6998
We must be notified in writing of any deletions within 72 hours of the person being terminated from the policy. Use the deletion form provided. This is necessary to protect you from any false claims.
To be always on time, we encourage everyone to either pay online, ACH or by credit card. We will debit your account each month. If you pay by credit card, there is a small processing fee of 5%.
CLAIM PROCEDURE FOR OCCUPATIONAL ACCIDENT INSURANCE
Any doctor may treat you. To be reimbursed for your medical expenses, claims must be reported within 20 days after the occurrence or commencement of any loss covered by the Policy, or as soon thereafter as reasonably possible.
The Company, upon notice of a claim may furnish to the claimant additional forms necessary for filing proof of loss.
All active, full-time independent Truck Owner-Operators and Co-Owners contracted with a motor carrier to haul commodities under and executed lease agreement and for whom the required premium has been paid and a completed enrollment form has been signed.
24 hours a day while under Dispatch from a motor carrier you have contracted with
• Accidental Death and Dismemberment
• Survivors Benefit
• Paralysis Benefit
• Severe Burn Benefit
• Accidental Medical Expense Coverage
• (includes Accidental Dental Expense coverage)
• Temporary Total Disability Coverage
• Continuous Total Disability
• Medical expenses related to accidental injuries
• Weekly and on-going disability payments due to injury
Visit NTA's complete website!