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Workers' Compensation Shop.com is your source for workers' compensation quotes, information, and forms for Arizona. We have compiled a list of downloadable forms, brochures, and guides for AZ employers and employees. Contact us if you need help locating a form or have questions about your policy or coverage in general. One of our Work Comp Specialists are ready to assist you.
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AZ Acord 130 Workers' Compensation Application
The standard Acord 130 application form for workers' comp coverage in Arizona.
Arizona Employer FAQ
Frequently Asked Questions for Arizona Employers- A Guide to Workers' Compensation in Arizona.
Arizona Notice to Employees
Arizona requires employers to post this notice of workers' compensation insurance in a place where employees will see it.
Arizona Employee Guide to Claims
Arizona guide to claims for injured employees.
Arizona Employer's Report of Injury Form
AZ Employers' Report of Injury Form. Employers should complete this form and send to their insurance company each time an injury occurs.
Arizona Employee's Report of Injury Form
AZ Employee's Report of Injury Form. Employee's should complete this form and send to their insurance company each time an injury occurs.
Workers' Compensation for the Injured Worker Information Booklet
A comprehensive booklet presenting information regarding workers' compensation insurance
Employers' Guide to Workers' Compensation
This is a document containing an overview of information pertaining to Arizona workers' compensation.
Arizona Notice of Rejection of terms
Form for the reduction or discontinuation of workers' compensation in Arizona.
Worker's Revocation of the Rejection of Terms
This form is for employees' whom have filed a rejection of the terms of Arizona workers' compensation law, and wish to revoke the rejection that they filed.
Each state has its own laws and requirements regarding when and how employers are allowed to opt-out of coverage under their workers' compensation policy. Some states make it easier than others because they don't require anything to be filed. Other states require special inclusion or exclusion affidavit documentation. Failure to comply often causes employers to have to pay premium on themselves even when they wanted to be excluded form coverage.
A waiver of subrogation means that a business and their insurance company is foregoing all rights to file suit, or seek damages, from another business. This is common in the construction industry as builders attempt to protect their company from negligence. A workers' comp waiver of subrogation does not prevent an injured employee from filing a lawsuit for damages. This coverage typically add about $100 to the cost of a work comp policy.
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A Certificate of Insurance is a document that serves as evidence of insurance or proof of coverage. Certificates indicate your current coverages and policy limits. Insurance Agencies issue on an insured's behalf and they often list a third party as a certificate holder. This means they should be notified if a policy cancels prior to expiration. Requests for any special wording should be carefully checked against the policy language before being added to a certificate as they can create legal issues with coverage.
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State Resources for Arizona
Arizona State Insurance Dept.
2910 North 44th Street Ste 210Phoenix, AZ 85018602-364-2499 Arizona Department of Insurance
Industrial Commission of Arizona
800 West Washington StreetPhoenix, AZ 85007602-542-4661 Industrial Commission of Arizona
Workers' compensation insurance is required by law for Arizona employers with one or more employees.
Arizona forms and applications such as owners inclusion or exclusion forms are sometimes updated by the state. Contact us if you need help or can't find the workers' compensation form your need for Arizona.
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