Report A Claim
Report A Claim
Please select the appropriate tab below for your state to Report a Claim.
Great Lakes Region
Servicing the states of Michigan, Ohio, Indiana, and Illinois
Report Online
Submit Michigan Workers’ Compensation Report
Report By Email
Report By Fax
Fax: (866) 712-1735
Email or fax your completed forms:
State of Michigan Pdf Form
State of Ohio Pdf Form
Central Region
Servicing the states of Minnesota, North Dakota, South Dakota, Nebraska, Iowa, and Wisconsin
Report By Email
Report By Fax
Fax: (651) 393-4880
Report By Phone
Phone: (800) 211-6389
Email or fax your completed forms:
State of Minnesota Pdf Form
South Region
Servicing the state of Alabama
Report By Email
Report By Fax
Fax: (877) 301-2008
Report By Mail
Mackinaw Administrators, LLC
PO Box 11047
Montgomery, AL 36111
Email, fax or mail your completed forms:
State of Alabama Form
East Region