Workers compensation claims

• It's your responsibility to notify us of all employee injuries as soon as the injury occurs.
•  
• 收集事实
  • 员工的名字
  • 社会pp王者电子官网号
  • Description of the accident
  • 证人姓名
  • 伤情描述
  
  
• 打开你的急救箱
  • Refer to the states listed below and locate the state(s) you operate in or the state(s) in which the injury occurred.
  • Download the 首次受伤报告 document and follow the instructions on the form.
  • Get details about how to mail, fax, or call in the claim.
  
  
• 报告你的索赔
  • 1-855-223-22801-855-223-2280
  • 传真 1-844-346-09691-844-346-0969
  • You may also mail the claim reporting form using the information in the claim kit.

How are benefit payments made?

• We pay medical and disability benefits as determined by individual state laws.
• Check with your agent or claim associate for complete details.

This is only a general description of coverages and is not a statement of contract. Details of coverage or limits vary in some states. All coverages are subject to the terms, 规定, 除外责任, and conditions in the policy itself and in any endorsements.

W在这里 can I get a claim kit?

All new and renewed policies contain a notice regarding claim kits, which provides step by step access instructions.

Select the state w在这里 your business is located for information on the workers compensation laws in that state.

有关 right side of the page includes state required bulletins and posters that need to be printed and displayed in your place of business. On the right side of the page you will also locate the “第一次受伤报告” 这是 YOUR RESPONSIBILITY TO USE TO NOTIFY US OF ALL EMPLOYEE INJURIES as soon as the injury occurs. You can download and print the 首次受伤报告 document from the same web page.

有关 左边 of the page is what you will need when reporting a claim, including phone and fax numbers and mailing address.

The forms available on this site are intended for the exclusive use of our policyholders and their agents. Claim Kits include important claims department contact information, instructions, and forms.

State Farm is working with WorkersCompensation.com to provide claim kits in order to make running your business easier.*