Insured Member
UCIC member schools can report incidents online, using the Injury Report below. We have also provided additional documents related to submitting workers' compensation claims.
Secure Information (PDF: 119KB)
Injury Report (PDF: 163KB)
Supervisor Checklist (PDF: 28KB)
Workers' Compensation Information (PDF: 12KB)
Notice of Rights and Duties (PDF: 132KB)
Physician Visit Report (PDF: 93KB)
SSC Medical Authorization (PDF: 14KB)
Fill out the web response card (below) if you wish to ask questions of peers through the University & College Insurance Consortium.