Claim Information
Available Claim Forms
To submit a claim use one of the appropriate links below. If none are available for your particular claim, please contact the appropriate company listed below or contact us directly.
Claim Information
Any time you have a claim to report it can be a stressful and traumatic time. Aaron Jones and Christine Huddleston are the liaisons between you, our insured and the company with which you are insured. Please call us with your claim reports or complete a claims report form.
Aaron Jones (309) 664-3691
After hours emergency claim number 1-309-261-2145
Work Comp First Report of Injury Form for Colorado
Work Comp First Report of Injury Form for Florida
Work Comp First Report of Injury Form for Georgia
Work Comp First Report of Injury Form for Illinois
Work Comp First Report of Injury Form for Indiana
Work Comp First Report of Injury Form for Kentucky
Work Comp First Report of Injury Form for Louisiana
Work Comp First Report of Injury Form for Michigan
Work Comp First Report of Injury Form for Minnesota
Work Comp First Report of Injury Form for Mississippi
Work Comp First Report of Injury Form for Missouri
Work Comp First Report of Injury Form for New York
Work Comp First Report of Injury Form for Oklahoma
Work Comp First Report of Injury Form for Pennsylvania
Work Comp First Report of Injury Form for South Carolina
Work Comp First Report of Injury Form for Tennessee
Work Comp First Report of Injury Form for Texas
Work Comp First Report of Injury Form for Virginia
Work Comp First Report of Injury Form for Wisconsin
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