AMLJIA

Call toll-free in Alaska 1-800-337-3682

Please advise AMLJIA claims office of all incidents and/or events. Remember, members can call with even a simple question.

When handling a claim, it is always critical for municipal and school officials to proceed carefully. In the event of an incident, injury or other loss, it is important to remember to:
ALWAYS	NEVER
Call AMLJIA immediately Take pictures of the damage Take pictures of the incident site Complete an incident report List witnesses & parties involved File police report (if necessary) File "'Report of Occupational Injury/Illness"	Admit liability Pay for a claim directly Put off filing a claim Disturb/alter the incident site Discuss confidential claims Make promises to claimants Forget to file required forms Take threats of claims lightly

Filing a claim is as easy as getting the information or report to AMLJIA. Mail or fax the information on the claim or potential claim. Once the information is received, an adjuster will be assigned to your claim. The file is sets up and assigned to an adjuster who will contact you. Then, the claim is investigated and processed.

Call toll-free in Alaska 1-800-337-3682, fax 907-279-3615

Claims Manager:

Johanna Grasso, johannag@amljia.org

Claims Adjusters:

Sandy Fazio, sandyf@amljia.org
Susan Sutton, sues@amljia.org
Diane Sanborn, Claims Assistant dianes@amljia.org

REPORT OF OCCUPATIONAL INJURY OR ILLNESS
Fax requests for additional copies of this form to: State of Alaska / Department of Labor (907) 269-4975. Ask for form 07-6101 and be sure to indicate number of forms you need. The form is also available on the Department of Labor web site at http://www.labor.state.ak.us/wc/forms/07-6101.pdf.

AMLJIA ACCIDENT LOSS NOTICE
Auto Accident Information Form
Property Loss Notice
General Liability Notice of Occurrence/Claim
Please use these forms to provide notice to AMLJIA.
Questions? Contact Johanna Grasso for additional information.

STUDENT ACCIDENT CLAIM FORM (PDF) click here
This form may also be obtained from Kate Young at katey@amljia.org or by calling 800-337-3682.
Student accident coverage benefits summary.

AUTHORIZATION FOR EMERGENCY MEDICAL TREATMENT FORM (PDF) click here
This form may also be obtained from Kate Young at katey@amljia.org or by calling 800-337-3682.