Report an Injury

Choose 1 of 4 ways to report an injury, including online through our First Report of Injury Portal.

1. Submit an Online Injury Report Now
In October 2020, our online injury reporting form was replaced by the First Report of Injury (FROI) Portal. New account registration is required before using the FROI Portal. 

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Note: A copy of the injury report will be emailed to any email address provided during submission. To protect privacy and data of our policyholders and their employees, MEMIC uses an email encryption service from Mimecast for sending messages and attachments that contain Personal Identifiable (PI) information. Access to the Mimecast Secure Messaging Portal requires creating a username and password. If no email address is provided, a copy of the report will be mailed.

pdf Mimecast Secure Messaging Portal Guide



2.  Call us at 1-800-MEMICWC or 1-800-636-4292



3.   Fax injury report form to 207-791-3334

Note:  Contact your state's workers' compensation agency for form.



4.  Mail injury report form to us within 24 hours:

MEMIC Claim Department 
PO Box 3606 
Portland, ME 04104

Note:  Contact your state's workers' compensation agency for form.

Email Encryption Service Change Notice

Effective May 12, 2021:

MEMIC switched from Symantec to Mimecast for email encryption service for sending secure messages. For your protection, existing users of the Symantec service will be required to create a new password upon first login to the new Mimecast Secure Messaging Portal. This is a one-time step and is not required on subsequent logins. We apologize for any inconvenience.

First Report of Injury Online Form Updates

COVID19

In response to the COVID-19 pandemic, the First Report of Injury (FROI) form has been updated with new selections for the cause and nature of injury fields. If you are reporting a COVID-19-related injury, please select “Pandemic” as the Cause of Injury and “COVID-19 as the Nature of Injury.

Please note that these codes should be applied regardless of confirmed diagnosis.

When utilizing the MEMIC FROI web portal, these selections can be found in the following locations:

  • Nature of Injury: Infections - Viral: COVID19
  • Cause of Injury: Contact: Pandemic

For Massachusetts FROIs:

  • Nature: Lung: COVID19
  • Cause: Contact: Pandemic

Reporting 101

report injuries by website or phone Watch Video

EPLI Claims

If you have added MEMIC EPLI to your policy and your claim is employment practices related, please call 1-877-310-3343 or email us at:

epli@memic.com

Have Questions?

Browse commonly asked ones about reporting claims and more.

FAQ for Employers