Welcome to the Claim Reporting Portal for
Old Republic Aerospace, Inc.
On this site you are able to enter a new workers' compensation claim.
If you have questions about a claim that has already been submitted, contact your adjuster directly.
To submit a new claim, follow these steps:
Print this page (optional).
Enter FIRST SIX NUMERIC DIGITS of your policy number.
Correctly complete the Captcha.
Click below on Proceed to claim entry
On the next page, enter the date of injury.
Answer the questions on each screen. Click NEXT to move from screen to screen.
Required questions are marked with an asterisk and must be answered before moving to the next screen.
On the confirmation page, click the link in the middle of the page to print a copy of the first report. The first report of injury will display. Print/Save a copy and note the loss number in the upper right corner of the form.
Proceed to claim entry
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BUILD: czr_rc CZR_20170215 patched on Thu, Mar 2, 2017 at 4:12:39 PM