NEED HOW TO SUBMIT
A CLAIM
NEED A WORKERS COMP FIRST REPORT
OF INJURY?
 Click on one of the links
below to download forms.
For other states contact
Donna Bartlett.
Indiana Claim Form
Illinois Claim Form

If you have a claim and are having difficulty contacting your carrier, please contact us.

CLAIMS CENTER
24 N. 6th St.
Terre Haute, IN
ph. 812.232.0441
fax 812.232.0926

If you prefer, report your claim to our office by choosing from one of the menus below.
SUBMIT BY FORM
SUBMIT BY EMAIL

Claims

Please use the following numbers to contact your insurance company for direct claim reporting 24 hours a day, 7 days a week.

ACCIDENT FUND 866-206-5851   ILLINOIS CASUALTY 800-445-3726
ACUITY 800-242-7666   INDIANA 800-279-7221
AIG 888-244-2736   IPEP 800-382-8837

ALLIED - Personal Lines

ALLIED - Commercial Lines

800-247-0363

866-322-3214

   LIBERTY MUTUAL 800-582-2503
AMERICAN INTERSTATE 800-699-6240   LIBERTY MUTUAL ASSIGNED RISK IL 800-772-1962
AMERICAN MODERN HOME 800-543-2644   LIBERTY MUTUAL ASSIGNED RISK IN 800-537-0822
AM COMP 800-749-1898   MEDICAL ASSURANCE / PROASSURANCE 800-284-7424
AMERISURE 800-752-5929   MILLER MUTUAL 800-768-7741
AUTO OWNERS 888-841-6467   NATIONWIDE AGRIBUSINESS 800-228-6700
BITUMINOUS 800-382-9991   NATIONAL FLOOD INS. 800-638-6620
BLISS MCKNIGHT 800-322-3391   NATIONAL FLOOD PLAN 800-637-3846
CENTRAL INSURANCE 800-736-7000   NATIONAL SPECIALITY / NSI 800-760-9250
CGU 800252-4609   NATIONAL SURETY 888-347-3428
CITIZENS/HANOVER 800-628-0250   NATIONAL UNION 888-244-2736

CHUBB

CHUBB - Workers Comp

800-252-4670

800-699-9916

   OLD REPUBLIC 800-927-2944
CNA - Personal Lines 800-588-7400   PROGRESSIVE 888-502-8330
CNA - Com'l except WC 877-262-2727   SAFECO 800-332-3226
CNA - Workers Comp 800-262-2727   STATE AUTO

800-766-1853
COMPANION 800-845-2724   TRAVELERS 800-252-4633
EMC 800-732-5595   UNITED FIRE 800-343-9131
FCCI 800-824-2513   WAUSAU 800-266-2800
FEDERAL SEE CHUBB   WEST BEND 877-922-5246
FIREMAN'S FUND 888-347-3428   ZURICH 866-488-2508
FRANKENMUTH 800-234-1133      
GREAT AMERICAN 800-545-4269      
GUARD INS. 888-639-2567      
HANOVER 800-628-0250      
HARLEYSVILLE 800-892-8877      
HARTFORD 800-553-1710      
HARTFORD STEAM BOILER 888-472-5677      
         
         
         

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©2009 Forrest Sherer Insurance, 24 N. 6th Street, Terre Haute, Indiana 47807 - 812-232-0441