Reporting Non-Industrial COVID Cases
- Retroactive reporting: All positive COVID tests between 7/6/20 to 9/16/20 must be reported, whether it is an industrial or non-industrial COVID case.
- Current and ongoing reporting: All positive COVID cases, whether industrial or non-industrial, between 7/6/20 and 1/1/23 must be reported within 3 business days of knowledge.
Workers’ Compensation COVID Specific Reporting Forms & Information:
AmTrust Insurance:
Benchmark Insurance:
COVID Tracking Form | Email to: nonwccovid@bmaclaims.com
BHHC:
COVID Tracking & Information for Policyholders | Email to: CovidReporting@bhhc.com
CompWest Insurance:
COVID Tracking Form | Email to: COVID19@AFGroup.com or Fax: 844-618-3636
Employers:
COVID Tracking Form | Email to: reportaclaim@employers.com or Fax: 775-886-1725
Hartford:
COVID Tracking Form (7/6/20 – 9/16/20) | COVID Tracking Form (9/17/20 – 1/1/23) | Resource Page | Email to: LossConnect@TheHartford.com or Fax: 800-347-8197
ICW:
COVID Tracking Form | Email to: firstnotice@icwgroup.com or Fax: 858-436-8916
Midwest:
COVID Tracking Form | Email to: caclaims@midins.com or Fax: 866.642.1234
Pacific Comp:
COVID Tracking Form (7/6/20 – 9/16/20) | COVID Tracking Form (9/17/20 – 1/1/23) | Email to: COVIDREPORTS@pacificcomp.com
Preferred Employers:
COVID Tracking Form | Email to: firstreport@peiwc.com or Fax: 866-921-7313
Republic Indemnity:
COVID Tracking Report | Email to: SB1159@ri-net.com or Fax: 866-448-1159
State Fund:
COVID Tracking Form | Resource Page | Email to: COVID@scif.com or Fax: 800-325-1284
The Zenith:
COVID Tracking Form (7/6/20 – 9/16/20) | COVID Tracking Form (9/17/20 – 1/1/23) | Email to: COVID1159Reporting@thezenith.com
Travelers:
COVID Tracking Form | Email to: covidexposure@travelers.com
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