Skip to Main Content
Menu Close
Friendly and proactive services for workers’ compensation claims
File a Claim

Select a state:

Procedures, providers, and processes differ by state. Select the state where payroll is finalized on the map or choose from the drop-down below to see specific information.

Alabama, Arizona, Arkansas, California, Colorado, District of Columbia, Florida, Georgia, Idaho, Illinois, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Maryland, Mississippi, Minnesota, Missouri, Montana, North Carolina, Nebraska, Nevada, New Jersey, New Mexico, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin

USL&H Claims

If you need to file a claim for a USL&H policy, please use the below forms:

USL&H Claim Kit

LS-202

LS-1

Temp Fill Form