Workers Compensation Claim Reporting Procedure

1. Call

 Please call our 24 hour claims hotline 1.888.CLAIM.50 to report any type of claim. High priority claims need to be reported via phone so they can be escalated to the proper person for handling.

2. Email

ClaimsReporting@Energi.com

3. Fax

978.531.4847

Documentation to Gather

When reporting you will be asked to provide a copy of medical documentation from the injured employee that seeks treatment. Should the injured worker be placed out of work beyond the State requirement a Wage Statement will need to be completed and submitted. Should the injured employee be put on Modified/Light Duty - medical documentation needs to be obtained and submitted referencing medical restrictions. For authorization form click here.

Notice of Litigation or Correspondence From an Attorney

The injured employee may seek legal counsel relating to his workers compensation injury. If this occurs, immediately forward that correspondance to Energi.

Comments, Concerns, Questions

If you have any questions regarding these procedures, please contact the Energi claims team.

Email: ClaimsReporting@energi.com
Phone: 978.531.1822 x314
Fax: 978.531.4847

Forms

Claim Form

For claims that are reported to our officer via email or fax, please complete the State First Report of Injury From.

Please choose your state from the drop down box below. Your State First Report of Injury will be listed as well as the State Wage form.



State of Texas Workers Compensation Links