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FILING A CLAIM

Welcome to Claims Center

Online, by phone or by email: File your claim, your way.

Report Your Claim Online

Expect a streamlined, efficient and user-friendly experience when you report your claim online.

  • Quick and easy claim reporting – anytime, anywhere.
  • Reach us immediately for prompt evaluation and resolution.
  • Easy access to electronically stored claims-related documentation.
File Online Now
Need to check on a previously filed claim? Call (800) 554-2642 or email claims@churchmutual.com.
Be sure to have your account number, policy number, and phone numbers for key contacts handy!
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Other Claim Filing Options

Claims Reporting Forms

Quickly and easily access the required forms for a variety of claim types.

Property and Liability Claims Forms

For incidents of property loss, automobile accidents and more, download the required claims forms here.

For damage to any of your property except vehicles.

For injury or property damage to others.

For injury or damage caused in an auto accident.

Workers’ Compensation Claims Forms

Depending on your organization’s location, you may need to file state-specific forms for workers’ compensation claims. Browse our forms by state and download those that are right for you.

Select your state

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For New York Customers Only*

NEW! DD-1 Form - New York Direct Deposit Requirements/Form

To receive your payment via electronic fund transfer, please complete and return the Direct Deposit Authorization form. If you choose to split your benefits between accounts, you must complete a separate form for each account you would like your benefits distributed to and include the amount to be placed in each account.

Once your request has been received, it may take up to three weeks to process. If additional information is needed your adjuster will contact you. The forms, or any claim documentation, can be sent with a clearly noted claim number via fax, email or mail.

California Medical Provider Network

We've partnered with Anthem to provide access to an extensive medical provider network (MPN). This MPN includes physicians who understand workers' compensation requirements and are experienced in providing expert care for injured employees.

Learn More

Submitting Claims Forms