Get Subrogation I Workers' Compensation

Filling out the Subrogation I Workers' Compensation form online is an essential step to ensure the proper evaluation of your claims. This guide will provide you with clear, step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to complete the Subrogation I Workers' Compensation form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the patient's name and identification number in the appropriate fields.
3. Indicate the type of accident by selecting the appropriate option: Auto/Motorcycle Accident, Work Related, Other Accident, or No Accident. Include the date and location of the injury or illness.
4. If you selected 'Auto/Motorcycle Accident' or 'Other Accident,' you need to specify if another person caused the accident. If yes, provide their name, address, and the insurance details.
5. If the injury is work-related, provide the employer's name and address at the time of the incident.
6. Indicate whether the employer or the workers' compensation carrier has accepted or denied liability.
7. Sign and date the form to confirm that the information provided is correct. Include your telephone number.
8. After completing the form, save your changes, download a copy, print the document if required, or share it as necessary.

Complete your Subrogation I Workers' Compensation form online now to ensure timely processing of your claims.