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We’ll Guide You Through the Claim Process

We do our best to help you ensure accidents don’t happen. However, when they do, we’ll be there to guide you every step of the way.

The first step is to file a claim within 24 hours of when an injury occurs. You will need the following information:

  • Policy number
  • Claim reported by: name, job, title, phone
  • Date of accident
  • Employee’s full name, address, phone
  • Employee’s social security number
  • Employee’s hire date and date of birth
  • Employee’s last day of work
  • Expected return-to-work date
  • Type of injury
  • Details on how the accident happened
  • Date the injury was reported to employer
  • Business location where the employee works
  • Employee’s supervisor’s name and phone

Once you’ve secured this information, you can easily file a claim online.

File a Claim


Other options for filing a claim:

Call us:

Email your claim information:

Send a fax:
517-216-2747; 866-814-5595

First Report of Injury Form 5020

Employee’s Claim for Workers’ Compensation Benefits DWC-1


Claims outside of California:

Send a fax: 866-835-5331