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
Submit a General Liability Report
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
Submit a General Liability Report
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
Submit a General Liability Report
East Region
Servicing the state of Massachusetts
