Report a Claim
ALICAP partners with Sedgwick for claims processing. Our experienced and knowledgeable claims adjusters are ready to help you! Their contact information is below:
Claims Adjusters
Sedgwick CMS
P.O. Box 14513
Lexington, KY 40512-4513
Phone: 1-800-486-2152
Fax: 1-402-496-6511
Beazley Cyber Security Hotline (24 Hours): 855-440-3400
Workers' Compensation Nurse Line (24/7): 855.364.9865, option 1
Claims Forms
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To be completed by supervisor. First report of alleged occupational injury or illness. This is an official public document.
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To be completed by employee. Employee's choice of doctor.
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Suggested form. To be completed by employee. District/ESU can use their own internal form. Report to be used by supervisor to assist in completing Nebraska Workers' Compensation Courts Form 1.
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To be completed by supervisor. Requested for all indemnity claims (claims involving loss of wages) - useful if completed on all claims, even those which are medical only.
