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.

Policy Information

Name of contact person reporting the injury

Injured Employee's Information