Who will handle your claims?
The New Jersey Regional Claim Office will handle your New Hampshire claims, located at:
305 Madison Ave
P.O. Box 1973
Morristown, NJ 07962
Phone: (888) 890-1500
Jeff Van Dyk, Assistant Vice President
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: crumandforsternol@cfins.com
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?
Employer’s Guide to Workers Compensation
Posting Notice
Prominently display the notice where each employee is likely to see the notice on a regular basis. The New Hampshire posting notice is available on the Crum & Forster website.
Employer’s First Report of Injury Form
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.
NH-Notice of Accidental Injury-7.1
Employer’s Wage Statement
NH-Supplemental Wage Schedule-4.14
Payment of Disability Compensation
Supplemental Report of Injury & Instructions
NH Supplemental Report of Injury-3.14
Waiting Period For Lost Wages in New Hampshire
The waiting period is 3 days. If the employee is off for more than 14 days, the first 3 days are paid retroactively.
Choice of Physician Rules in New Hampshire
The employee is entitled to the initial choice of physician.
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: https://www-sf.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
H. Dept. Of Labor WC Division- https://www.nh.gov/labor/workers-comp/index.htm
Multi-State Information- http://www.workerscompensation.com/