NOTIFY US OF A CLAIM > Reporting forms can be found in your policy packet and below. Upon receipt of your claim, we will file the appropriate documents with the proper regulatory authorities in your state.
Email - firstname.lastname@example.org
Phone - (866) 866-9199
Fax - (601) 427-1588 / (844) 263-3311
Mail - Post Office Box 1380, Ridgeland, Mississippi 39158
WHEN TO NOTIFY US >
Please report all claims to AmFed immediately to ensure prompt investigation and payment of benefits as a delay may result in penalties. The wage information section on the claim reporting form must be completed on claims with disability or anticipated disability (used to establish the compensation rate).
IMPORTANT TIPS >
FIRST Report OF Injury Forms (by State) >
PLEASE NOTE THAT ONLINE FORMS CAN ONLY BE SUBMITTED USING INTERNET EXPLORER (GOOGLE CHROME BROWSER WILL NOT TRANSMIT THE DOCUMENT).