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Friendly and proactive services for workers’ compensation claims
File a Claim

Select a state:

For serious/catastrophic after-hours claims, please contact our toll-free Reporting Hotline:1-866-337-0891.

Procedures, providers, and processes differ by state. Select the state on the map in which payroll is finalized, or choose from the drop-down below to see specific information.

Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Maryland, Michigan, Mississippi, Minnesota, Missouri, Montana, North Carolina, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, West Virginia, Wisconsin

USL&H Claims

If you need to file a claim for a USL&H policy, please use the below forms:

USL&H Claim Kit

LS-202

LS-1

Temp Fill Form

Medical Billing

Medical Bills Can Be Mailed To:

P.O. Box 14365
Lexington, KY 40512

Process medical bills electronically by signing up today with E-Billing Benefits.

Western Integrated Care, on behalf of Benchmark Administrators Payer ID is LV191.

General Inquiries

800-362-5198