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Get Workers Compensation Claims Kit Dear Policyholder - CastlePoint ...
T REPORT OF INJURY OR ILLNESS STATE OF UTAH - THE LABOR COMMISSION - DIVISION OF INDUSTRIAL ACCIDENTS 160 E 300 S, P.O. BOX 146610 SALT LAKE CITY, UTAH 84114-6610 EMPLOYER (Name & Address Incl. Zip) G E N E R A L CARRIER ADMINISTRATOR CLAIM NUMBER OSHA LOG NUMBER REPORT PURPOSE CODE JURISDICTION JURISDICTION CLAIM NUMBER INSURED REPORT NUMBER EMPLOYERS LOCATION ADDRESS (IF DIFFERENT) INDUSTRY CODE LOCATION # EMPLOYER FEIN PHONE # CARRIER/CLAIMS ADMINISTRATOR C L CARRIER (NAME. ADDRESS.
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Dependents FAQ
If you have a policy with The Hartford, you can file a workers' comp claim online. If you need help to file a workers' compensation claim, call 800-327-3636.
Filing a Car Insurance Claim With The Hartford Is Easy You can call to report an auto claim at 800-243-5860, 24 hours a day, 7 days a week. You can also report a simple car accident claim online. Here are three of the most common types of online car insurance claims:
Promptly file a Written Notice of Claim: In Connecticut, you must file Form 30C, which gives notice to the Workers' Compensation Commission that you are claiming benefits. Although you notified your employer that you were injured, you must file the Written Notice, Form 30C, as well.
Workers' compensation insurance (also known as workman's comp insurance) provides benefits to employees and their families for work-related injuries and illnesses. Workman's comp insurance helps cover your employees' medical bills and some, or all, of their lost wages if they suffer a work-related illness or injury.
If you're having an issue with any aspect of a coverage or claim, we want to hear about it. Use our complaint form to tell us your contact information and some coverage information. Someone from our customer complaint team will reach out to you after you submit your complaint.
Claim Kit means the information, documents and materials, including the Claim Form, that a Settlement Class Member must submit under the Claims Program to process the Settlement Class Member's Claim, the contents of which will substantially conform to subsection 7.4.
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