When an employee injury occurs:

  1. SEND EMPLOYEE FOR TREATMENT: Refer to the medical provider list included in your policy or contact us at (800) 372-2428. Call 9-1-1 if the injury is an emergency.
  2. REPORT THE CLAIM TO US WITHIN 24 HOURS: All forms submitted after 10 a.m. EST will not be processed until the next business day. Please notify us via phone immediately at (800) 372-2428 if the injury is severe and cannot wait until the next business day.

Important: Claimant's full name, date of birth and social security number are REQUIRED to set up a claim



Submit Michigan Workers' Compensation Report Online

State of Michigan Paper Form

General Liability Paper Form

Property Loss Paper Form

Automobile Loss Paper Form



State of Ohio Paper Form

Ohio BWC link


Paper forms can be submitted via:

Fax: 866-712-1735
Mail: Mackinaw Administrators, LLC     
        P.O.Box 489
        Brighton, MI 48116