Workers' Compensation Toolkit

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This kit is provided to new workers' compensation policyholders and their agents, as well as to all current policyholders when their policies renew. It contains important claims department contact information, instructions, and forms.


Florida Contact Information:

Nationwide Insurance - East Office
One Nationwide Gateway, Dept. 5570
Des Moines, IA 50391-5570
(800) 889-9872
Fax: (800) 363-8904

Agribusiness Mailing Address for Claims Related Mail
1100 Locust St., Dept 3010
Des Moines, IA, 50391-3010
Phone: (800) 228-6700
Fax: (800) 842-1482

 

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Florida Compliance Information

Posting Requirements

Reporting Of Claim By Employer

Penalties for Late Reporting

Physician Selection


Posters and Publications

POSTER - Anti-Fraud Poster Required


POSTER - Anti-Fraud Poster (Spanish) Required

POSTER - Broken Arm Poster - 11 x 17 Size Required

POSTER - Broken Arm Poster - 11 x 17 Size (Spanish) Required

BROCHURE - Important Workers' Compensation Information for Florida Workers Required

BROCHURE - Important Workers' Compensation Information for Florida Workers (Spanish) Required

BROCHURE - Important Workers Compensation Information for Florida Employers Required

BROCHURE - Important Workers Compensation Information for Florida Employers (Spanish) Required

BROCHURE - An Employer's Guide to a Drug-Free Workplace

Employee Notification Letter

Employee Notification Letter (Spanish)


Forms

First Report of Injury or Illness


Wage Statement

Request for Social Security Disability Benefit Information

Authorization and Request for Unemployment

Mileage Reimbursement Form






Please Note: The information on this site is maintained by a third-party, Nationwide does NOT warrant or represent that the information will be error-free. Your use of the site is on an as-is basis, at your sole discretion and risk. The site is for informational purposes, and nothing included in the site shall replace the need for qualified legal counsel. We recommend that you consult with legal counsel, agents, or risk managers regarding workers' compensation obligations.

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