Texas Builders Insurance Company

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Claims Forms

Below are claims forms you can download.

Supplemental Report of Injury
Employers Wage Statement
Employers First Report of Injury or Illness
Employee’s Claim for Compensation - English
Employee’s Claim for Compensation - Spanish
Chapter 122. Compensation Procedures - Claimants
Chapter 120. Compensation Procedures - Employers

Get in Touch

(512) 708-0148 fax: (512) 708-9486 claims fax: (512) 708-9487 Texas Builders Insurance Company PO BOX 164050
Austin TX 78716
info@tbic.com

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Injured Workers

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