File a Claim
Claim Forms & Report Only Forms are located at the bottom of this page.
Workers' Compensation (WC):
When an employee gets injured, the affected employee and/or the supervisor are to call (855) 477-2266 as soon as practical. The call will go directly to MPR’s Nurse Triage program to speak with a registered nurse who will determine treatment options. Obvious emergency injuries should be directly referred to your 911 operator.
After the claim is filed MPR will provide the employee with a workers’ compensation advocate to assist them through the claim’s process.
Automobile Claim Report:
To submit an auto claim, the standard Automobile Claim Form must be filled out and electronically sent to: Claims@MPRisk.org or call (816) 842-4800.
Liability Claim Report:
To submit a liability claim, the standard Liability Claim Form must be filled out and electronically sent to: Claims@MPRisk.org or Call (816) 842-4800.
Property Claim Report:
To submit a property claim, the standard Property Claim Form must be filled out and electronically sent to: Claims@MPRisk.org or Call (816) 842-4800.
Cyber Incident or Claim:
If you have a cyber incident or a claim please contact:
Kylee Cundiff, CLCS
Client Service Manager Sr.
2345 Grand Blvd.
Suite 400
Kansas City, MO 64108
kylee_cundiff@ajg.com
Office: 816.329.0818 | Fax 816.218.0818
CLAIM FORMS
Incident Investigation
Auto Report
of Incident
Liability Report
of Incident
Property Report
of Incident
REPORT ONLY FORMS
Minor Injury Exposure Report
Liability Report Only
