Auto, liability, and property claim forms
Members can submit auto, liability, and property claims using any type of format that is most convenient. Here are some forms developed by LMCIT. Submit these types of claims as soon as you can.
Workers’ compensation claim forms
Here are the requirements for filing a workers’ compensation claim, according to Minnesota’s Workers’ Compensation Statute:
- Claim must be submitted on a First Report of Injury (FROI) form.
- Claim must be submitted within 10 days of first knowledge of an employee’s injuries (given a death or serious injury, claim must be reported by phone within 48 hours and a FROI must be submitted within seven days of injury). Employers must provide employees with a copy of the Minnesota Workers’ Compensation System Employee Information Sheet at the time the employee is given a copy of the FROI.
- First Report of Injury (pdf): Use this form to report injuries to employees or emergency response volunteers (including paid on-call volunteers)
- Volunteer Accident Form (doc): Use this form to report injuries to all other volunteers who do general volunteering (such as those helping with park and rec programs, homeless shelters, and special events)
- Workers’ Compensation System Employee Information Sheet (pdf)