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Workers' Compensation

Report a Claim

Did you know you can log in to report your claim online? It is fast, your claim is assigned to a representative immediately, and you can view your claim status throughout the process. It may take up to 2 business days to assign your claim using the form below. To report other types of claims, visit our Claim Support Center.

Required fields are marked with an asterisk (*)

Contact Information

You'll enter the injured employee information later.

Loss Information

Location of loss

Injured Employee Details

Were medical services provided?
Did the injury result in a fatality?
Did the employee miss any workdays?