Benefits
Workers' Compensation
Provider:
Church Mutual Insurance Co.
Contract No. 0500002-07-945470 (Effective 07/01/08 – 06/30/09)
P.O. Box 342
Merrill, WI 54452-0342
Phone: 1-800-554-2642 Fax: (715)539-4651
Contacts:
Laurie Buck, Claims Service Representative
1-800-554-2642, Option 4, Ext. 4854
Wendi Weinkauf, Claims Processor (NC)
1-800-554-2642, Option 2, Ext. 4662
The following procedures should be followed in filing a workers' comp claim:
- All work related injuries must be filed within 5 days after knowledge of the injury or accident.
- The parish/school must complete a NC Industrial Commission Form No. 19 provided by Church Mutual. Download the form here (PDF).
- The completed form should be mailed or faxed directly to: Church Mutual, P.O. Box 342, Merrill, WI 54452 / Fax: (715)539-4651.
- A copy of the claim should be kept at your location.
- A copy of the workers' compensation claim should be sent to the Diocesan Benefits Office.
- All subsequent bills relating to the claim should be sent to directly to Church Mutual.
[Rev. 07/01/08]