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

[email protected]

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

[email protected]

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

[email protected]

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

Servicing the state of Massachusetts

Report By Email

[email protected]

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