Workers' Compensation: Claims Injury Reporting
ERIE's Workers' Compensation Customers are required to report any work related injuries immediately by:
- Calling us at 1-855-492-3665.
ERIE will file all required reports with the state workers' compensation agencies. For your reference, visit the state agency websites to view the forms for first report of injury.
Injury Information ERIE Will Need
Information to have on hand when you call ERIE to report an injury:
- Workers’ Compensation Policy Number
- Date of Injury
- Time injury occurred
- Your Company tax ID number
- Name and telephone number of contact person (owner, manager)
- Date employer was notified of injury
- Address of where injury occurred
- Name, address and telephone number of injured worker
- Employee’s social security number
- Date of birth, sex, and marital status
- Number of dependents
- Occupation/job title
- Date of hire
- Description of how the injury happened
- Type of injury and exact body part injured
- Is the employee full time or part time
- What is the employee’s normal starting time
- Has the employee lost any time from work
- Was the employee paid full wages for the date of injury
- Return to work date
- Names of any witnesses
- Name, address and telephone number of physician or hospital
- Wage information (hourly, weekly)
Fax ERIE at 1-855-792-3665. For more information, contact your local ERIE Agent.
If you suspect insurance fraud, call ERIE's toll-free Fraud Hotline at (800) 368-6696 or make a report by email: firstname.lastname@example.org.