Workers' Compensation Notice
For your convenience, a new Acord form is available for you to report your claim. This form requires the use of Acrobat Reader 4.x or greater. If you have questions about using the forms, please review help.

When you have finished entering the data, you can print or save the form as a pdf file. The information will be submitted in an Acrobat PDF form. 

After your claim has been submitted, you will receive confirmation your claim has been received and you will be provided another opportunity to save the PDF form for your records. If you do not receive a confirmation email, please contact us.

  

  

 Workers' Compensation Guidelines

 

 

 

If you need the Acrobat Reader, you can download it for free:    Get FREE Acrobat Reader