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Claim Submission Process
New Mexico

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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 |
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 |
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: For Claim Kit information, please contact SUA at 877-782-3291 New Mexico Employer's First Report of Injury or Illness - NM WCA Form E1.2 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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