Report a Claim Online

Do any of the following conditions apply to your claim?

  • Death
  • Amputation
  • Blindness or loss of eye
  • Brain Injury
  • Paraplegia
  • Burns of more than 20 percent of the body
  • Quadriplegia or severe paralysis

Due to the severity of the claim, this must be reported via telephone to LUBA at 1-888-884-5822.

Note: if the call is after hours, the answering service will contact the LUBA claims department immediately.

Please be aware that if an injury involves a fatality, amputation, or loss of an eye, it must be reported to OSHA immediately.  Please call their free and confidential number at 1-800-321-OSHA (6742) to report.

Please be aware that if an injury involves a fatality, amputation, or loss of an eye, it must be reported to OSHA immediately.  Please call their free and confidential number at 1-800-321-OSHA (6742) to report.

Policy Information

Name of contact person reporting the injury

Injured Employee's Information