Central Region
Contact Us
Central Region
Servicing the states of Minnesota, North Dakota,
South Dakota, Nebraska, Iowa and Wisconsin
Region Contact
Doug Ellington
SVP Regional Manager
Claims Contact
John Wiatros
AVP Regional Claims Manager
Risk Control Contact
Gary L. Smith MLIR, CRM, CSRM
AVP, Director National Loss Control
Report a Claim
Report By Email
Report By Fax
Report By Phone
Email or fax your completed forms:
Minnesota Employer’s First Report of Injury Form