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Below, you can gain easy access to all necessary forms and publications, all with just a few clicks. And remember, we have designed this site to be a resource center for both agents and policyholders , but if you need help beyond the scope of this site, do not hesitate to contact us directly.


AGENT FORMS AND PUBLICATIONS
  • Standard ACORD Application
  • Producer Agreement
  • Indemnity Agreement
  • Rejection of Coverage
  • Wage Designation
  • Work Experience
  • Construction Supplemental Questionnaire
  • Trucking Supplemental Questionnaire
  • No Loss Statement
  • Underwriting Guidelines
  • FAQs from Agents
  • Fund Overview for Agents
  • Who We Are Brochure
AUDIT FORMS AND PUBLICATIONS
  • Premium Audit Brochure
  • Self-Reporting Audit
  • State Quarterly Unemployment Forms
  • Federal Quarterly 941 Forms
  • Federal 1099 Forms
MEMBER INSURED FORMS AND PUBLICATIONS
  • Second Injury Fund Brochure
  • Accident Investigation
  • Application for Employment
  • Application for Employment (Long Form)
  • Second Injury Fund Questionnaire Revised 2009
  • WC First Report of Injury
  • Claims Brochure
inGOODcompany Archive
  • December 2009 - Volume 1 - Issue 1
  • June 2010 - Volume 2 - Issue 1
  • April 2011 - Volume 3 - Issue 1
  • September 2011 – Volume 3 – Issue 2
  • February 2012 – Volume 4 – Issue 1
  • July 2012 – Volume 4 – Issue 2
  • November 2012 – Volume 4 – Issue 3
  • January 2013 – Volume 5 – Issue 1
  • April 2013 – Volume 5 – Issue 2

Louisiana Construction and Industry Self Insurers Fund (LCI Workers' Comp) | 1123 North Causeway Boulevard • Mandeville, LA 70471 | Phone: (985) 612-1230 | Fax: (985) 612-1240 |