Injured Worker Claims
Injured Worker Claims
Getting your injured worker immediate medical attention is the most important first step. Use the information below for:
- Reporting your claims
- Claims kits
- Finding a medical provider (for non-emergencies)
REPORT ONLINE:
It’s fast, easy and convenient and allows for 24/7 claims reporting.
Receive a confirmation number after submission.
REPORT BY PHONE: (800) 825-9489
Please have your policy number and name of insured/policyholder as named on the policy.
Please have the following claimant information:
Full name, age, date of birth, social security number
Date/hours of employment and wages
Date, time and location of injury
Home address and phone number
REPORT BY E-MAIL: [email protected]
REPORT BY FAX: (855) 603-8409 (Yep, we can still do that!)
Email or fax your completed State Workers’ Compensation First Report of Injury form.
Download Claim Forms by State
In order to email or fax your claim, you will need a state has a special form. In order to access those, click the link above.
Find a Medical Provider Network
( Except California )
Medical E-Bill Solutions
Meadowbrook partners with WorkCompEDI to accept electronic billing for Workers’ Compensation Medical bills. Providers may contact WorkCompEDI to establish an electronic billing partnership. Meadowbrook’s electronic billing payer ID is WR778.
( California MPN Information )
Many MPN forms, notices and materials are available for download. If you are in the need of any notifications regarding the medical provider network that is required to be given to an employee you may email the MPN contact.
