To report an injury, call Summit’s 24-hour hotline
1-800-762-7811
It is important that you call the injury hotline as soon as possible.
Here’s what you’ll need—
- Injured employee’s name and date of birth
- Employee’s address and phone number
- Social Security number
- Date of hire
- Occupation/position
- Wage information
- Number of hours/days the employee works per week
- Date/time of injury
- Date the injury was reported
- Description of the injury/accident
- If the employee has already seen a doctor for this injury, please provide the doctor’s name and phone number
- Your business location
- Contact person at your business
- Workers’ compensation policy number
We recommend that you call the hotline to report any workplace injuries. The notice of injury forms below can be filled in on the screen and printed or you can print out the form for your state and fill it in manually. Fax the completed form to 863-667-1871.
|
