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Claim Submission Process
Illinois
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Click on the form and complete in its entirety.
NOTE: Blank fields may delay our ability to service your claim. |
Step 2
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Print or save the form to your hard drive. Please click on the First Report of Injury form found in the Forms, Documents, and Information section of this screen. |
Step 3
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To submit a claim:
E-mail (preferred method):
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Toll Free Fax #: 877-782-3292
Toll Free Phone #: 877-782-3291
Standard Mail:
SUA Insurance Company
P.O. Box 06110
Chicago, IL 60606-6110
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Forms, Documents and Information
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For your convenience, please find the following forms, instructions, and resources:
SUA Illinois Claims Kit
Illinois Form 45: Employer’s First Report of Injury
This form is required to be completed by the employer immediately following an employee injury or accident.
To Request Workers' Compensation Posting Notices and Template Stickers click here.
Claim Questions
Inquiries should be directed to: 877-782-3291
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Workers Compensation