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Here is a list of all the forms, applications, and manuals related to Workers' Compensation Insurance in the state of Maine. We strive to keep this up to date and accurate.
As with all of the information we provide you should always confirm with the state directory to make sure you are using the most up to date material.
If you have any questions about where to find or how to fill out one of these or any other form, please feel free to call one of our Workers' Compensation Experts at 888-611-7467.
Maine Acord 130 Workers' Compensation Application.
The standard Acord 130 application form for workers comp coverage in Maine.
Maine First Report of Injury Form.
Maine First Report of Injury Form. Employers should complete this form and send to their insurance company each time an injury occurs.
Maine Application for Exclusion of Officers and Stockholders.
Complete this form if you are a sole-proprietor, partnership or an officer of a corporation and would like to be exempt from coverage.
Maine Application for Exemption for Workers' Compensation Insurance
Complete this form to file a claim for workers' compensation.
Application for Waiver Instructions
This document contains instructions for completing the Application for Waiver.
Employer Employee Agreement
Complete this document when an agreed settlement has been reached between the employee and employer in the case of permanent impairment.
Forms and Petitions Manual
A comprehensive collection of workers compensation forms and instructions for the state of Maine.
Rules and Regulations
A comprehensive collection of workers compensation rules and regulations for the state of Maine.
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.
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.
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.
Improve your business cash flow with our Agency Pay As You Go Workers' Comp plans. Available through most of our insurance companies.
State Resources for Maine
Maine Bureau of Insurance
Consumer Services Division34 State House StationAugusta, ME 04333-0034800-300-5000 www.state.me.us/pfr/insurance/
Maine Workers' Comp Board
27 State House Station Map ItAugusta, ME 04333-0027888-801-9087 www.maine.gov/wcb/
Workers compensation insurance is required by law for Maine employers.
Maine 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 Maine.
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