Broker Information

New York State Insurance Fund
Workers’ Compensation Claims

Filing a New Claim

Should I File a Claim?
The completion of a C2, Employer’s Report of Injury, is mandatory unless the claim falls into a “First Aid” or “Category A” claim. These claims can be handled internally; however, rec ords of the injury must be maintained by the employer for 18 years.

Instructions for Reporting a Claim
Review the Keevily, Spero-Whitelaw instructions for reporting a Workers’ Compensation Claim.

Report Claim Online
The benefit of reporting claims online is that the State Insurance Fund begins their processing and investigation immediately. The appropriateness of medical treatment, the facts surrounding the alleged accident and the validity of the injury will be investigated faster than if the C2 was sent by mailed or fax. After completing the electronic C2, print two copies. Keep one for your records and mail or fax the second to Keevily, Spero-Whitelaw.

IMPORTANT – Keevily, Spero-Whitelaw will NOT be able to monitor the claim and assist you with limiting lost work days and other cost cutting measures immediately if you, the insured, do not send us a copy of the electronic C2.

Report a Claim by Fax or Mail
Complete the C2 and
- Fax the completed form to 914-381-1134.
or
- Mail the completed form to
Keevily, Spero-Whitelaw
500 Mamaroneck Ave
Harrison, NY 10528

C2 - Employer's Report of Injury pdf icon


Managing an Existing Claim


Keevily, Spero-Whitelaw has developed tools designed help your company reduce the cost of claims, shorten disability periods and eliminate abuse or fraud. We have a staff of Workers’ Compensation professionals who are available to assist you with claim issues or to help you incorporate these programs into your existing safety program.
Accident Investigations pdf icon
Fraud Prevention pdf icon
Early Return to Work Program pdf icon

Below are some links to additional resources to assist in your claim processing.

NYSIF
Claim Guide for the Employer
Report Fraud or Abuse
Employer’s Claim Inquiry
Injured Worker’s Inquiry / Where’s my Check?
Injured Worker’s General Inquiry

Workers' Compensation Board
C11 Form / Employer's Report of Injured Worker's Change in Employment Status
C240 / Employer's Statement of Wage Earnings

OSHA
OSHA Recordkeeping







 

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500 Mamaroneck Ave, Harrison, NY 10528   |   Tel · 800 · 523 · 5516   or   914 · 381 · 5511   |   Fax · 914 · 381 · 1134