AmFed Claim Reporting

Workers' Compensation - First Report of Injury

AmFed strives to bring its clients new and innovative products and services that can help save time. Submit and/or print First Report of Injury on-line using the appropriate link below:

Select a First Report of Injury based on the State of Jurisdiction:

Mississippi, Illinois & Arkansas

Submit any of the above forms on-line or print the form and fax it to AmFed.

Additional Instructions:
The FROI form is provided in PDF format. You must have Adobe Acrobat Reader to view and print these forms. Click the link to the right to download Acrobat Reader. Once you have opened the form and entered your information, scroll to last page and click on the Submit button to electronically sent your data to AmFed. For assistance, email claimsdesk@amfed.com.