If a member cannot use the online claim submission tool, they can submit completed claims forms by emailing them to [email protected] with a copy to [email protected].
**UPDATE** DWC-1 Forms are now emailed after the claim is uploaded into the claims system. You will now receive one email with the data you input and a second email with the DWC-1 form. Note that the DWC-1 Form was updated and looks slightly different.
Use the link below to complete the Loss Notice. Once the information is entered, be sure to indicate “yes” and enter the email address that the Loss Notice information and DWC-1 should be emailed to.
DWC-3 and DWC-6 forms may be entered at the above link as well.
New users need to request access to Juris Global Intake to submit claims online by emailing a completed Juris Global Intake Request Form to [email protected].
If you have a username and need help resetting your password, contact the Help Desk at 866-647-7610, option 2 (Monday-Friday 7:00-7:00). You may also email [email protected].
