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We offer free access to most forms necessary for workers' comp coverage in the state of Montana. We work hard to keep these forms accurate and up to date.
As with all information we provide please verify the accuracy of this information with the Montana Department of Labor and Industry.
If you have questions, feel free to contact one of our experts at 888-611-7467. For faster service you can start a quote online.
MT Acord 130 Workers' Compensation Application.
The standard Acord 130 application form for workers' comp coverage in Montana.
Montana First Report of Injury Form.
MT First Report of Injury Form. Employers should complete this form and send to their insurance company each time an injury occurs.
First Report of Injury of Occupational Disease Instructions
Instruction to help properly complete and file the First Report of Injury or Occupational Disease Form.
Montana Workers' Compensation Coverage Election/Rejection Form for Sole Proprietors
Complete this form to select elect or reject workers' compensation coverage for Sole Proprietors, Partners, and LLCs in the state of Montana.
Montana Workers' Compensation Coverage Election/Rejection Form for Officers
Complete this form to select elect or reject workers' compensation coverage for officers in the state of Montana.
Application for Insurance Coverage Instruction/Information
Information and instructions to assist completing the Application for Insurance Coverage for the state fund.
Application for Insurance Coverage
Complete this Application for Insurance Coverage to apply for insurance from the state fund.
Workers' Compensation Insurance and Safety Program Brochure
This is an information highlight of the Montana Workers' Compensation Insurance and Safety Program and application for the Chamber of Commerce.
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 Montana
MT Dept of Labor and Industry
P.O. Box 8011Helena, MT 59624-8011406-444-6532 http://dli.mt.gov/
MT Work Comp Regulation Bureau
P.O. Box 8011 1805 Prospect AvenueHelena, MT 59624-8011406-444-6541 http://erd.dli.mt.gov/
Workers' compensation insurance is required by law for Montana employers.
Montana 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 Montana.
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