Reporting A Claim
To find a medical provider in your area, please refer to the provider list included in your policy or contact us at 1-800-372-2428. Call 9-1-1 if the injury is an emergency.
Submit Michigan Report OnlineState of Michigan
State of Illinois
State of Indiana
State of Missouri
State of Ohio
State of Ohio BWC
State of Wisconsin
IMPORTANT: We MUST have the injured employees full name, date of birth and social security number to set up a claim.
Please note: All forms submitted after 10:00 am EST will not be processed until the next business day. Please notify us via phone immediately at 1-800-372-2428 if the injury is severe and cannot wait until the next business day. Please note that all injuries should be reported within 24 hours.
What To Do Next?
Download and fill out the appropriate form. After completion you can submit the form by either of these methods:
Mail: P.O. Box 489, Brighton, MI 48116