Massachusetts Insurance Inquiry Form

State:
Massachusetts
Control #:
MA-SKU-1070
Format:
PDF
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Description

Insurance Inquiry Form

The Massachusetts Insurance Inquiry Form is a document used to gather information about a person's insurance coverage. It is typically used by insurance companies to determine eligibility for certain types of policies, such as health insurance, auto insurance, and life insurance. The form includes basic information such as name, address, phone number, and Social Security number, as well as questions about the type of coverage and the date of the last policy review. There are two types of Massachusetts Insurance Inquiry Forms: the Standard Inquiry Form, which is used for general inquiries, and the Special Inquiry Form, which is used for more specific requests or to request additional information. Both forms are available online from the Massachusetts Department of Insurance.

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FAQ

All employers operating in Massachusetts are required to carry workers' compensation insurance for their employees and themselves if they are an employee of their company. The requirement applies no matter the number of hours worked or the number of employees.

1-877-MASSAFE (627-7233). The Executive Office for Administration and Finance oversees workers' compensation for state employees.

Calling 617-635-3193, or. emailing workerscompstaff@boston.gov.

1-877-MASSAFE (627-7233). The Executive Office for Administration and Finance oversees workers' compensation for state employees.

You can also call our Office of Insurance for assistance at (617) 626-5480 or (617) 626-5481, or look up your employer's insurer online. If your employer doesn't have workers' compensation insurance, you will need to file a claim against the Workers' Compensation Trust Fund, which is part of the DIA.

If you were injured at work, you may be eligible for workers' compensation benefits. If you qualify, you can receive payments to partially replace your paycheck and for medical care related to your injury. You may also be eligible for vocational rehabilitation if you need help getting back to work.

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Massachusetts Insurance Inquiry Form