Workers’ Compensation Claim Kit – Wisconsin

Who will handle your claims?
The Milwaukee Regional Claim Office will handle your Wisconsin claims.

Phone: 800-242-4566
Jeanine Ramstack, AVP

Please direct all general correspondence to:

Email:    claimsmail@cfins.com
Fax:        877-622-6911
Mail:      PO Box 14139, Lexington, KY  40512

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?

WC12 – Employer’s First Report of Injury (This is to be filed with the insurance company at the initial reporting of the accident):

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.

WI-First Report of Injury

What is the Waiting Period for Lost Wages in Wisconsin?
The waiting period is 3 days. If the employee is off more than 6 days, the first 3 days are paid retroactively.

What is the Choice of Physician Rules in Wisconsin?
Employee has choice of physician and up to one 2nd opinion (referrals do not count). Insurance company has right to Independent Medical Exam (one time exam).

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:

Wisconsin Workers’ Compensation Website https://dwd.wisconsin.gov/wc/

Wisconsin WC Forms – https://dwd.wisconsin.gov/wc/about-us/formsorder.htm

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