• - Its important to provide detailed loss information to assist in the claim handling process
  • - The completed claim form will be sent to the Care Center for registration and claim office assignment
  • - A claim confirmation will be sent to you with the email provided acknowledging receipt of claim

Worker's Comp - Report a Claim to Zurich NA

Correct the errors highlighted below

Insured
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Contact
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Reported By
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Accident
Please note: if this box is checked, this claim is reported as Record Only. No action will be taken by Carrier.
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Claimant

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Employer
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Employee
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Loss of Work
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Injury
Additional Notes
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