We help business owners navigate Indiana workers' comp rules.

We offer free access to the most common forms needed relating to Indiana Workers Compensation Insurance. We strive to keep these forms up to date and accurate. It is important that you confirm with the state website to ensure you are using the most up to date versions of these forms.

As with all the information we provide about state workers comp rules please verify the accuracy of this information with the Iowa Department of Workers Compensation.

We want to be your go to resource for all information relating to workers compensation insurance in the state of Indiana. If you have any questions about any of these forms feel free to contact one of our Workers Comp Specialists at 888-611-7467. If you are ready you can start a quote online today.

Indiana Workers Compensation Insurance 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.

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.

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.

Workers' Comp Exemption

Each state has its own laws and requirements regarding when and how employers are allowed to opt-out of coverage under their workers compensation policy. Some states make it easier than others because they don't require anything to be filed. Other states require special inclusion or exclusion affidavit documentation. Failure to comply often causes employers to have to pay premium on themselves even when they wanted to be excluded form coverage.

Waiver of Subrogation

A waiver of subrogation means that a business and their insurance company is foregoing all rights to file suit, or seek damages, from another business. This is common in the construction industry as builders attempt to protect their company from negligence. A workers' comp waiver of subrogation does not prevent an injured employee from filing a lawsuit for damages. This coverage typically add about $100 to the cost of a work comp policy.

Certificate of Insurance

A Certificate of Insurance is a document that serves as evidence of insurance or proof of coverage. Certificates indicate your current coverages and policy limits. Insurance Agencies issue on an insured's behalf and they often list a third party as a certificate holder. This means they should be notified if a policy cancels prior to expiration. Requests for any special wording should be carefully checked against the policy language before being added to a certificate as they can create legal issues with coverage.


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State Resources for Indiana

Indiana Department Of Insurance

311 W. Washington, Ste. 300
Indianapolis, IN 46204
317-232-2385
Indiana Dept of Insurance

IWorker's Compensation Board of Indiana

402 West Washington Street Room W-196
800-824-comp
http://www.in.gov/wcb/

Workers compensation insurance is required by law for Indiana employers.

Indiana forms and applications such as owners inclusion or exclusion forms are sometimes updated by the state. Contact us if you need help or can't find the workers compensation form your need for Indiana.

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We've developed Target Programs with key insurance companies that provide bigger discounts and more credits.

Visit NCCI for more resources and information about workers' compensation class codes. Visit United States Department of Labor for more information about government agencies managing workers compensation insurance rates.

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