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Indiana Workers Compensation Forms

Workers Compensation Insurance States Indiana IN Workers Comp Forms


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Indiana Workers Compensation Insurance
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Welcome to our forms library for Indiana.  We offer free access to the most common forms, guides, and applications related to Indiana workers compensation insurance.

Please choose a form below to download.  If you have questions about our forms or need help finding a form please contact us.  One of our Indiana Work Comp Specialists will be glad to help answer your questions or help you get started on quotes today.

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Questions? Call 888.611.7467 for a Workers Compensation Shop Specialist


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Indiana Workers Compensation Forms

Indiana Acord 130 Workers Compensation Application

The standard Acord 130 application form for workers comp coverage in Indiana.

Indiana First Report of Injury Form

First Report of Injury Form.  Employers should complete this form and send to their insurance company each time an injury occurs.

Indiana Application for Exclusion of Officers and Stockholders

Owners and Officers of corporations should complete this form to exclude themselves from a workers' compensation policy.

Indiana Application for Exemption for Workers' Compensation Insurance

Complete this form if you are a sole-proprietor, partnership with no employees or an sole officer of a corporation and would like to be exempt from coverage.

Facts for Injured Workers In Indiana

Information about workers compensation in Indiana for workers and employers.

Indiana Independent Contractors Certificate of Exemption Application

The required application for all independent contractors who want to be exempt from workers comp coverage in Indiana.  Must be filed with the Indiana Department of Revenue.

Indiana State Resources

Worker's Compensation Board of Indiana

402 West Washington Street Room W-196
Indianapolis, Indiana 46204
(800) 824-COMP

Indiana is under the Jurisdiction of the National Council for Compensation Insurance (NCCI) and contracts with Travelers as the state fund carrier.

Our agency can help employers find guaranteed fund coverage in IN.  We also help employers with State Fund policies find more affordable coverage with private carriers.

Start an Indiana workers compensation quote online today or call us at 888.611.7467 to see if you qualify for more affordable coverage.


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Indiana Workers Comp Quotes

We offer access to national workers compensation coverage.  Our agency specialized in workers comp insurance and we have streamlined the process to make if fast and easy to qualify for the best rates and premiums in Indiana, and throughout the United States.


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