How to file a claim

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Four steps to take when filing a claim

Step 1

Get employee medical treatment if serious. Call 911, if necessary. Forms can be completed after treatment is provided. Otherwise, follow the next steps and send the employee to a designated medical provider.

Step 2

Complete Employer’s Report of Accident (form K-WC 1101-A). Mail or e-mail completed form to:

KMIT Claims
PO Box 26721
Overland Park, KS 66225
KMIT@CISInsuranceSolutions.com

-OR-

KMIT Claims Medical Bills Only
PO Box 11321
Overland Park, KS 66207
KMITinbox@comptechgroup.com

Step 3

Provide employee with a copy of Important Information for Injured Employees (form K-WC 27).

Step 4

Provide employee with Authorization For Work Comp Medical Treatment form. Complete the top portion and instruct the employee to have the doctor complete the bottom portion. Instruct the employee to being completed form back to the supervisor after the doctor’s appointment with the designated physician.

All of the forms mentioned above can be found on the website in our “document center.” Each form is in PDF form so you may print for your use.

For help or questions regarding any claim, please contact:

Gene Miller, KMIT Claims Manager
Phone: (844) 682-2266
Fax: (816) 214-4080
Email: GMiller.KMIT@CISInsuranceSolutions.com