You can report a claim in four ways:
For a serious accident, call us immediately:
The forms linked here are in Portable Document Format (PDF), that requires them to be downloaded and printed using Adobe Acrobat software. If you do not have Adobe Acrobat Reader, you can immediately obtain this free software at www.adobe.com/products/acrobat/readstep2.html
Prompt filing of the correct forms with all the necessary information helps speed claim investigation and the proper payments of any benefits. Late filings or late payments may also result in penalties imposed on your company and/or A.I.M. Mutual Insurance Companies as your insurer.
In Massachusetts, there is no statutory requirement to report claims involving less than five calendar days of disability to the Department of Industrial Accidents (DIA). It is critical, however, that medical-only claims be reported to A.I.M. Mutual Insurance Companies in a prompt fashion. File a medical-only report with us using the A.I.M. Works Med-Fax form.
Lost time cases must be reported within seven calendar days, not including Sundays and legal holidays. The reporting period is seven days from the receipt of notice of any injury alleged to have arisen out of and in the course of employment. Further, the injury must incapacitate an employee and keep him or her from earning full wages for a period of five or more calendar days. File lost time first reports with us using the (Form 101) Employer’s First Report of Injury or Fatality. A copy of Form 101 must be given to the injured worker and kept with your file. We will then file the Form 101 with the DIA regardless of the method you use to report a claim to us.
See the Massachusetts Statutory Benefit Provisions for the current level of benefits under Massachusetts workers compensation law.
For a serious accident, call us immediately at 1.866.270.3354.
In New Hampshire, an Employer’s First Report of Occupational Injury or Disease (8WC form) must be filed with the Department of Labor within five days of receiving a notice of an industrial accident.
Lost time cases require the 8WC form as well as the Employer's Supplemental Report of Injury Form 13 and Wage Schedule (76 WCA form)
We will file these forms on your behalf.
An additional form, Notice of Accidental Injury or Occupational Disease (8aWCA), may also be necessary. Complete this form and send a photocopy along with the Employers First Report of Occupational Injury or Disease (8WC form) to A.I.M. Mutual. Keep a copy for your records and give a copy to the injured employee.
If you phone in or report a new claim over the Internet, a completed Form 8WC will be sent to you. If the claim is originally reported to us as a medical only claim, but the injured employee is then disabled for four or more calendar days, please notify us by faxing or mailing Form 13WCA to us; we will then file it the with Department of Labor.
New Hampshire workers compensation law mandates that employers give injured employees the opportunity to work in an alternative capacity. The law applies to employers with five or more employees.
Specifically, employers must identify and design alternative job duties with the intent of returning the injured employee to his or her original job as quickly as possible. Working directly with the injured employee, the health care provider and your A.I.M. Mutual Claim Representative will determine the best way to develop alternative job duties that meet the needs of all involved.
For a serious accident, call us immediately at 1.866.270.3354
For a medical-only claim, please complete the A.I.M. Mutual Med-fax form and return it to us. If the injury results in incapacity for one day or more, please complete and return the First Report of Injury (FRI).
A.I.M. Mutual will notify the State of Connecticut Workers Compensation Commission in the event a medical-only claim changes to lost time.
NOTE: If at any time you receive a Notice of Claim for Compensation Form 30C submitted by one of your employees, it is imperative that you immediately send it to A.I.M. Mutual and, if applicable, contact the adjuster assigned to your account.
For all other claim reporting forms and more detailed reporting instructions, go to the Workers Compensation Forms Library.