Complete the online form below to file immediate notification of a Workers’ Compensation injury to Prescient National.
Telephonic Reporting is also available. Dial 1-877-327-5444 to report your claim by phone.
Get Started: Employer Information
The web form will take approximately 15-20 minutes – please make sure you have adequate time before starting the process as you will not be able to return to the form at a later time.
Before you begin, please have all essential details available (Claimant SSN, birthdate, hire date, etc.) and document attachments (Post-offer Medical Questionnaire, medical notes, witness statements, etc.). DO NOT CLICK THE BROWSER BACK BUTTON – You will have the opportunity to make changes before submitting the form.
Acceptable browsers: Chrome, Firefox and Edge (Internet Explorer users: this form requires Microsoft Edge).
If you have problems with the form or if you have any questions, please contact us at email@example.com or (704) 927-2860
We are Prescient National.
And together with you, we’re creating solutions that will yield greater benefits in the long run.