Insurer Telephone Number To Get Oregon Claims Processing Location Information
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Insurer Telephone Number To Get Oregon Claims Processing Location Information Form. This is a Oregon form and can be use in Insurer And Self Insurer Workers Comp.
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Tags: Insurer Telephone Number To Get Oregon Claims Processing Location Information, 4865, Oregon Workers Comp, Insurer And Self Insurer
Insurer telephone number to get Oregon
claims processing location information
Workers’ Compensation Division
Note: The telephone number will be posted on the Workers’ Compensation Division (WCD)
employer coverage Web site.
Information to be published on the Web:
Insurer:
(
)
-
Telephone number to get processing
location information (mandatory):
Web-based claims location look-up
(optional):
Claims processing location mailing address for insurers with a single Oregon processing
location (optional):
Address:
City:
State:
ZIP+4
-
Contact for questions or issues on above information:
Please provide the name of a person or department within your company we can contact for any questions or issues that
come up about the above information you have provided. WCD will not publish the following contact information on
our external Web site.
Contact name:
Title:
Address:
City:
State:
(
)
-
Phone:
ZIP+4
(
)
-
-
Fax:
E-mail address:
This information was submitted by:
Contact name:
Title:
Address:
City:
State:
ZIP+4
American LegalNet, Inc.
www.FormsWorkFlow.com
(
)
-
Phone:
(
)
-
Fax:
E-mail address:
Mail this form to:
Workers’ Compensation Division
Attn: Insurer Registration
P.O. Box 14480
Salem, OR 97309-0405
or fax it to:
503-934-6048
440-4865 (9/09/DCBS/WCD/WEB)
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American LegalNet, Inc.
www.FormsWorkFlow.com
