Report a Claim

Worker’s Compensation

Claim Form

Fax Worker’s Compensation Claim Form to United Heartland at 1-866-814-5595

or e-mail [email protected]

Claim Reporting by Phone: 1-888-881-8242

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Liability

Claim Form

Fax Liability Claim Form to Statewide Services at  800-858-1536

or e-mail [email protected]

Notice & Disallowance of Claims

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Auto Physical Damage

Claim Form

Fax APD Claim Form to Statewide Services at  800-858-1536

or e-mail [email protected]

Here is our block quote.