First Report of Injury

You must complete all information to file your claim. If the injury resulted in a fatality please submit using the paper WKC-12 Employers First Report of Injury or Disease and submit directly to the Department of Workforce Development and Wilson Mutual within 24 hours of the fatality.

 

As a reminder all claims need to be submitted to Wilson Mutual within 7 days from the date of the injury.

 

Your claim will be processed during normal business hours. If you have questions regarding your claim, please contact your agent or The Wilson Mutual Claims Department.

 

The provision of your social security number is voluntary, failure to provide it may result in an information processing delay. Personal information you provide may be used for secondary purposes.

 
First Report of Injury

Required Fields Are In Bold