Workers’ Compensation Claim Kit – Maine

Who will handle your claims?
The New Jersey Regional Claim Office will handle your Maine claims, located at:

305 Madison Ave
P.O. Box 1973
Morristown, NJ 07962

Phone: (888) 890-1500
Jeff Van Dyk, Assistant Vice President

How to Report Workers’ Compensation claims?

To report via the Internet: Log on to the Crum & Forster website at https://cfconnect.cfins.com. Use your assigned User ID and Password. If you do not have a current User ID, please contact your local Crum & Forster Claims or Marketing resource.

To report e-mail: crumandforsternol@cfins.com
To report via fax: 1-877-622-6218
To report claims via telephone: 1-800-690-5520

(7 day/24 hour toll free reporting line for all states)

  • In the event of a serious or fatal injury, notify the local claim office immediately by telephone.

What forms and pamphlets does the employer need to be aware of?

Notice of Injured Worker Rights and Responsibilities
Prominently display the notice where each employee is likely to see the notice on a regular basis. The Maine posting notice is available on the Crum & Forster website.

Employer’s First Report of Injury form
If you report the claim via the Internet or by telephone, you do not need to fill out this form. If you report the claim via fax, complete this form, and fax it to Crum & Forster at the fax number provided above.

WCB-1 Form Form Instructions

Maine-FROI 1-2013 Maine-Forms Manual 8.14

Employer’s Wage Statement
File this form with the carrier, claimant, and claimant’s representative when the claimant is losing time from work.

Maine-WCB-2rev 1.13

Waiting Period for Lost Wages in Maine
The waiting period is 7 days. If the employee is off for more than 14 days, the first 7 days are paid retroactively.

Choice of Physician Rules in Maine
The employee is entitled to the choice of physician after specified time.

Preferred Provider Organization Network (PPO)
Crum & Forster has a PPO network available. Follow the instructions below to access the PPO Network:

Logon to the website at: https://www-sf.talispoint.com/conduent/cfi/

  • Search by Provider Address, Name or Region
  • Select the Distance, Provider Type and Specialty
  • Results can then be exported to a directory or excel.
  • You can obtain a Map List or text message by selecting a specific provider

Where should all medical bills be sent?
Crum & Forster
PO Box 14801
Lexington, KY 40512

Important Websites

Maine Workers’ Compensation Division- http://www.maine.gov/deh/workers/index.html

Maine W/C Forms- https://www.maine.gov/bhr/owc/forms

Multi-State Information- http://www.workerscompensation.com/