File A Claim

Report a new workers’ compensation claim immediately. The earlier a claim is reported the sooner it can be resolved. Do not wait to report the claim until the medical bills have arrived.

Claims can be reported 24/7 using any of the following methods:

  1. Complete the online form below and submit through the website.
  2. Complete the Standard Intake Form and fax or email to the contact info at the top of the form.
  3. Call our third-party administrator, Sedgwick Claims Management. The number to report a claim is 866.764.7705. Policyholders should reference Retailers Insurance and/or our contract number, 1578, when reporting a claim. Before reporting a claim via phone, policyholders are encouraged to review the Standard Intake Form to see the information that will need to be provided over the phone.

Serious injuries or death claims
Report serious injuries and death claims immediately, by phone, to Sedgwick. In the event of a death, employers must also notify the state within 8 hours by calling 800.858.0397. If a work-related inpatient hospitalization, amputation or eye loss occurs, employers must notify the state within 24 hours by calling 844.464.6742.

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