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Reporting an Injury

Prompt injury reporting is the single, leading factor in controlling the cost and duration of an injury claim. Chesapeake Employers makes injury reporting easy 24/7!

When an employee requires medical treatment and needs prescriptions filled for a work-related injury, provide the employee with a copy of the Temporary Prescription Services ID Form to take to the pharmacy. When this completed form is presented to the participating pharmacy, the prescriptions are filled with no out-of-pocket expenses for the employee.

Online Reporting

Click on eServices Log In to create a profile and register for a User Name and Password.  If you already registered, then go directly to the eServices Log In.  Once the information is submitted, you will receive immediate confirmation, a claim number and information for the Express Scripts pharmacy program.

Express Scripts: When an employee requires medical treatment and needs prescriptions filled for a work-related injury, provide the employee with a copy of the Temporary Prescription Services ID Form to take to the pharmacy. When the completed form is presented to the participating pharmacy, the prescriptions are filled with no out-of-pocket expense for the employee.

24-hour Injury Reporting Hotline

Call us toll-free at 1-888-410-1400. A customer service representative will take the information over the telephone and give you a claim number and Express Scripts number.

Fax Transmittal or Mail

To submit the First Report of Injury by fax or mail, please manually complete the ACORD 4 First Report of Injury form. Then forward the completed form either by fax to 410-494-2002 or send by mail to: Chesapeake Employers' Insurance Company, 8722 Loch Raven Boulevard, Towson, MD 21286. (Important: We strongly recommend that employers report the injury via our toll-free injury reporting hotline or use our online injury reporting service. Reporting the injury via our hotline or online injury reporting capability is more convenient and faster than manually completing the form.)

Our Claim Filing Responsibility

After we have received the Employer’s First Report of Injury (FROI), we mail a hard copy of the report to the:

    • Employer;
    • Agent;
    • Maryland Workers’ Compensation Commission; and
    • Department of Labor.

 

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Chesapeake Employers' Insurance Company •  Formerly the Injured Workers' Insurance Fund • 8722 Loch Raven Blvd. • Towson, MD 21286   410-494-2000  1-800-264-4943   Privacy Policy and Data Security