Workers' Compensation

Workers' Compensation Program

We provide coverage for workers’ compensation losses incurred under the State of California Workers’ Compensation Law and Statutes and within the limits of program coverage. MSIA claims are handled by our third-party claims administrator, Sedgwick.

The Pooled Workers’ Compensation Program provides coverage in excess of various limits retained by the members. MSIA retains the first $600,000 of each loss for workers’ compensation and employer’s liability and shares the risk among the members. For more information about this program, as well as additional layers of excess coverage in place, please contact our staff.

Workers' Compensation Forms and Reference Material

For DWC-1 (Claim Form)

Form 5020 (Employer’s Report of Occupational Injury or Illness)

MSIA WC Desk Reference Manual

Time of Hire Pamphlet

For additional Workers’ Compensation Forms and Documents linked here