Workers Compensation Claim kit – Indiana

Who will handle your claims?
The Milwaukee Regional Claim Office will handle your Indiana claims, located at:

375 Bishops Way, Suite 225
Brookfield, WI 53005

Phone: 800-242-4566
Jeanine Ramstack, Regional Director 

How to Report Workers’ Compensation Claims?

To report via the Internet: Log on to the Crum & Forster website at https://cfconnect.cfins.com. Use your assigned User ID and Password. If you do not have a current User ID, please contact your local Crum & Forster Claims or Marketing resource.

To report e-mail:                                      [email protected]
To report via fax:                                     1-877-622-6218
To report claims via telephone:       1-800-690-5520

(7 day/24 hour toll free reporting line for all states)

  • In the event of a serious or fatal injury, notify the local claim office immediately by telephone.

What forms and pamphlets does the employer need to be aware of?

#SF 34401 / Employer’s First Report of Injury:
If you report the claim via the Internet or by telephone, you do not need to fill out this form. If you report the claim via fax, complete this form, and fax it to Crum & Forster at the fax number provided above.

3440Ir9

What is the Waiting Period For Lost Wages in Indiana?
The waiting period is 7 calendar days. This is not paid unless the employee is off for more than 21 days.  This is cumulative and does not start over when the employee returns to work.

What is the Choice of Physician Rules in Indiana?
The employer/insurance company directs medical treatment.

Preferred Provider Organization Network (PPO)
Crum & Forster has a PPO network available. Follow the instructions below to access the PPO Network:

Logon to the website at:   www.talispoint.com/conduent/cfi

  • Search by Provider Address, Name or Region
  • Select the Distance, Provider Type and Specialty
  • Results can then be exported to a directory or excel.
  • You can obtain a Map List or text message by selecting a specific provider

Where should all medical bills be sent?

Crum & Forster
PO Box 14801
Lexington, KY 40512

Important Websites:

Indiana Workers’ Compensation Website – http://www.in.gov/workcomp

Indiana WC Formshttp://www.in.gov/workcomp/forms/

Multi-State Information: http://www.workerscompensation.com/