File a Claim With
Cimarron Insurance

To ensure that an injured employee receives the care they need and their workers' compensation claim is managed in a professional manner, it is imperative that claims be reported in the first 24 hours. The information on this page is designed to assist you with the process.


When an employee is injured, follow instructions prescribed by Medcor. Provider Search can be found on our website and as directed by our Medcor Triage Nurse.

  • Provide employee reporting forms required for your state.
  • Employee should sign forms as required.
  • Employer should file forms as required and comply fully with your duties as described in part four of your workers compensation policy.
  • All injury forms are available via our website: under File a Claim. Employer must file even if the employee prefers not to see a physician.

Reporting instructions by fax or e-mail

  • Cimarron Insurance encourages the employer to report any injury within 24 hours.
  • As an employer, the law requires that you report an employee injury within five days of notification.Failure to do so could result in a fine and possible policy cancellation.
  • Timely reporting will facilitate employee wellness.
  • All injury forms are available via our website: under File a Claim.Getting reporting assistance by telephone
  • To ensure accuracy in completing forms, employers are encouraged to call for assistance.
  • You will be greeted on the telephone by a Claims Representative who will assist in completing the
    Report of Injury form for your state.
  • The questions are designed to gather key information to begin the claim reporting process.Employers please note: The filing of reporting forms is not an admission of employer liability. Report objective information as it was reported to you. Subjective opinions can be reported in a separate coversheet.

If you are unsure as to what to do or need guidance, we encourage you to call Brentwood Services Administrators at 877-296-6378 and ask to speak with a claims professional.

For Questions Contact Claims Administration

Cimarron Insurance Company
P.O. Box 471127
Charlotte, NC 28247-1127

p: 877-296-6378
f: 704-543-0609


How to Report an Amigo Auto Claim

By Phone: 855-226-4466

Select Option 4. Be ready to provide details about your accident.

Report a Claim

How to Report a Workers Compensation Claim

By Phone: 833-359-0188

By fax: 704-543-0609

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