Reporting an Injury

Need to file a claim? . . . No problem!
We provide three (3) methods to submit the First Report of Injury form, including our quick and easy

Online First Report of Injury Form.



Claims Kit

If you do not have your original Employer Claims Kit, you may download the documents online.

Full Claims Kit




Account Loss Runs

Agents are given FAST ACCESS to Account Loss Runs. As an affiliated agent you may request your Account Loss Runs online and your reports will be generated and emailed to the email address on file in one business day or less.

Request Account Loss Runs


Supplemental Underwriting Forms

Complete these class codes and industry specific underwriting forms and provide to your underwriter so the prospective risk’s can be better understood for acceptability and pricing analysis.

Supplemental Underwriting Forms



Please feel free to Contact Us if you don’t see the form you need.