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Report a workers’ compensation claim and start the process here.

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Do you need help reporting a workers’ compensation claim? We’re here to help make the experience as simple and convenient as possible.

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Report a Workers’ Comp Claim to Erie

Click here to learn how to submit a workers’ compensation claim through Erie.

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Report a Workers’ Compensation Claim

If you have questions or prefer to speak to one of our claim advocates, complete the form below and we’ll be in touch to assist you with your claim. That’s why we’re here.

Name of Manager
Date of Injury
Date Employer was Notified of Injury
Address Where Injury Occurred

Injured Worker

Injured Worker: Name
Injured Worker: Address
Injured Worker: Date of Birth
Injured Worker: Sex
Injured Worker: Marital Status
Injured Worker: Date of Hire
Injured Worker: Full Time or Part Time
Injured Worker: Hourly or Salary
Injured Worker: Date Returned to Work (if applicable)

Medical Provider

Medical Provider: Address
This field is for validation purposes and should be left unchanged.

Report Your Claim Directly

Click the link below, find your insurance provider, and follow their process.

Find Your Insurance Company

Meet Our Founder

The agent behind Empire Insurance Agency.

Meet Our Founder

Contact Empire Insurance Agency

Our Vestal, NY Office

4100 Vestal Road, Suite 102
Vestal, NY 13850

 607-724-0404 text
570-531-8006 fax
Email Us
 607-724-0404

Prefer to speak with someone from Empire Insurance Agency?
Contact us directly.

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