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While we hope you never experience a workplace injury, we want you to be prepared in the event you need to report a claim. If an employee is injured, your State Farm® agent can help with questions about workers compensation insurance or to start the claims process.
To help you with the claim process, a workers compensation claim kit is available to policyholders and agents. The claim kit contains important claims department contact information, instructions, and forms.
This is only a general description of coverages and is not a statement of contract. Details of coverage or limits vary in some states. All coverages are subject to the terms, provisions, exclusions, and conditions in the policy itself and in any endorsements.
All new and renewed policies contain a notice regarding claim kits, which provides step by step access instructions.
Select the state where your business is located for information on the workers compensation laws in that state.
The information on the right side of the page includes state required bulletins and posters that need to be printed and displayed in your place of business. On the right side of the page you will also locate the "First Report of Injury," which is YOUR RESPONSIBILITY TO USE TO NOTIFY US OF ALL EMPLOYEE INJURIES as soon as the injury occurs. You can download and print the First Report of Injury document from the same web page.
The information on the left side of the page is what you will need when reporting a claim, including phone and fax numbers and mailing address.
The forms available on this site are intended for the exclusive use of our policyholders and their agents. Claim Kits include important claims department contact information, instructions, and forms.
State Farm is working with WorkersCompensation.com to provide claim kits in order to make running your business easier.*
*Products and services are offered by WorkersCompensation.com. State Farm does not warrant the merchantability, fitness or quality of the products and services offered by WorkersCompensation.com.
State Farm does not write workers compensation insurance in Canada, Maine, Massachusetts, Montana, North Dakota, Ohio, Rhode Island, Washington, West Virginia, or Wyoming.
This proprietary system pre-fills certain claims office and insurance company data on some forms.
Your Adobe Reader program may prompt you to "trust" the source of the files — please designate this as a trusted source in order for that information to be pre-filled for you.
For Technical issues related to accessing forms and content in the Claim Kits, please call (888) 406-5855 (888) 406-5855.
For questions related to policy and coverage please call (855) 264-2229 (855) 264-2229.