Serving Connecticut's Healthcare Employers For Over 25 Years

Report a Claim

To report a claim, please click here for the First report of injury form. You then have 2 options:

  1. Complete the form on-line, print and fax to 203-294-0082 or
  2. Save the blank form to your desktop and use as needed. Once completed, you can either fax to the number above or email it to us at 1streport@wctrust.com .

If you have any questions, contact 1-800-506-2655.

For electronic filers: click here

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