Ask An Adjuster

Please fill out the form below as thoroughly as possible for a complete response regarding your question. The more information you can provide, the better. Disclaimer:The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for individual advice regarding your own situation. This feature of our website is only available for existing Telamon clients.



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Company Name *
Last Name, First Name *
Telephone Number *
Email Address *
Date of Injury
Address where injury occurred
Was medical care provided?	Yes No
Dates of medical care provided?
Please explain specific details as to occurrence of injury and part(s) of body affected.
Please give a detailed description of your question (either a general question or claim question). *
Claim Filing Entity	Employer Insurance Carrier Other
Carrier ID Number
Carrier Case Number
Has the employee returned to work?	Yes No

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