The League organized and administers the New Mexico Self Insurers' Fund, which offers Workers' Compensation, general liability, law enforcement, civil rights, errors and omissions, auto liability, auto physical damage, and property and volunteer coverage to its members.
Please Note: If you are faxing any material concerning claims or underwriting to the Self Insurers' Fund, please use the following fax number: 505-522-8033.
Note 1:(Submit Employer’s First Report of Injury or Illness (E-1) by email: Workers Compensation Claims)
Note 2:(Notice of Tort Claim may be submitted by email: Liability Claims)
2022 Safety Workshops
Defensive Driving Course - 2nd Tuesday of every month - see events and training for registration information.
- Workers Compensation Average Weekly Wage Worksheet (PDF)
- Notice of Accident Form (PDF)
- Notice of Tort Claim Form (PDF)
- Property Loss Claim Form (PDF)
- Employers First Report of Injury or Illness (E-1) (PDF)
- HIPAA Complaint Medical Release Form (PDF)
- Choice of Healthcare Provider (PDF)
- Election of Benefits Form (PDF)
- Auto Physical Damage Loss Claim Form (PDF)
- Inland Marine Equipment Loss Claim Form (PDF)
- IRS W9 (PDF)
- NMSIF Medical Travel Reimbursement Request NEW 1-11-23 (PDF)