Form/template
2
min
read

First report of injury form

Early reporting can save you money. Report all injuries immediately! The information below allows
Back to Knowledge Center

Early reporting can save you money. Report all injuries immediately! The information below allows Pinnacol Assurance's customer service representatives to quickly and accurately process your claim. Use the completed form as a guide when reporting by phone or online to save you time. Don't wait to report if you don’t have all the answers.

View in Spanish

View
PDF
COVID-19 policy update