Report an Injury

MCIM’s Claims Department provides several easy and convenient methods to report workers’ compensation injuries, as well as responsive follow-up and monitoring. Once we receive a claim, either by phone, fax or online, be assured it will be promptly reviewed by our claims staff. With workers’ comp, quick response is critical for effective and efficient management.  Our examiners stay involved in each case, monitoring medical treatment in addition to keeping the policyholder and injured worker fully informed.

To use our FROI system (online First Report of Injury), please select the First Report of Injury menu option from the Insured section of your My MCIM menu, or click here.

NOTE: If you have not requested access to this feature, email us at  [email protected] to sign up.

To help expedite the handling of a claim, the following options are available by clicking on the appropriate form below for your State. 
(NOTE: Adobe Acrobat Approval, Standard, or Professional version 5 or newer is required for submitting these forms by email.)
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• Florida - First Report of Injury
• Georgia - First Report of Injury
• Illinois - First Report of Injury
• Indiana - First Report of Injury
• Michigan - First Report of Injury​

You may call, fax or e-mail the completed injury report to:
Phone: 888.922-5246
Fax: 941.921-0640
[email protected]