Workers’ Compensation Claim Kit – New Hampshire

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
Diane Parrish, Regional Director

How to Report Workers’ Compensation claims?

To report via the Internet: Log on to the Crum & Forster website at 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:
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

NH-Employer’s Guide

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-FROI 12.14

NH-Notice of Accidental Injury-7.1

Employer’s Wage Statement

NH-Wage Schedule-9-15

NH-Supplemental Wage Schedule-4.14

Payment of Disability Compensation

NH Payment of Disability-94

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:

  • 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-

Multi-State Information-