Employer defense intake that captures claim dates and insurer status
Ask whether the contact is authorized to speak for the employer, whether a workplace injury claim already exists, and whether the insurer has denied coverage or reserved rights — then collect claim documents before a consultation gets booked.
The exact intake your employer defense leads complete
This is the real 7-question guided intake for Employer Defense — the same flow your customers finish before you ever pick up the phone.
What a qualified employer defense lead should tell you
Legal representation for an employer facing a workers' compensation claim, dispute, hearing, or insurer coverage issue involving one of its employees — as opposed to representing the injured worker.
- Contacting Us On Behalf
- There Workers’ Compensation Claim,
- Injury Or Claim Happen
- Business Facing Dispute, Investigation,
- Workers’ Compensation Insurer Denied
- This Claim, Dispute, Or
- Know Employee’S Name And
The questions your team needs answered
Every employer defense intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Are you contacting us on behalf of a business as the employer (owner, manager, HR, or authorized representative)? | Employer defense work requires an authorized representative of the business, not the injured worker, so this answer determines whether the caller matches the practice at all. |
| Is there a workers’ compensation claim, workplace injury report, or related dispute involving one of your employees? | Without an actual claim, injury report, or dispute on file, there's nothing yet for an employer defense attorney to defend. |
| Did the injury or claim happen in the United States? | A workers' comp claim tied to an injury outside the US falls outside a domestic defense practice's jurisdiction. |
| Is your business currently facing a dispute, investigation, hearing, lawsuit, or potential penalties related to this workers’ comp matter? | A live dispute, investigation, hearing, or lawsuit signals the matter has moved past routine claims handling and needs active legal defense now. |
| Has your workers’ compensation insurer denied coverage, reserved rights, or said it may not defend you in this matter? | When the insurer denies coverage or reserves rights, the employer often needs independent counsel rather than carrier-appointed defense, which makes this a strong indicator of real need. |
| Did this claim, dispute, or notice occur within the last 3 years? | Claims and disputes older than three years may run into procedural or statutory limits, so recency affects how actionable the matter still is. |
| Do you know the employee’s name and the date (or approximate date) of the alleged injury? | Knowing the employee's name and approximate injury date shows the employer has organized the claim file, which speeds up the initial consultation. |
How Cliont scores employer defense leads
Every answer is weighted automatically — no manual review required.
Value signals
- Contacting Us On Behalf: yes
- There Workers’ Compensation Claim,: yes
- Injury Or Claim Happen: yes
- Business Facing Dispute, Investigation,: yes
- Workers’ Compensation Insurer Denied: yes
- This Claim, Dispute, Or: yes
See the lead your team receives
Employer Defense Lead
From first click to qualified lead
Follow people and businesses seeking counsel through one smooth, guided flow.
They land & meet you
Your video greeting plays instantly — a real face instead of a blank form.
They explain the matter
Smart questions adapt to their matter and capture the full scope.
They share the documents
The facts, dates, and any paperwork come attached, so you can assess the matter before the consultation.
You get a ready lead
Scored and qualified — waiting for you to win it.
Built for employer defense workflows
| Cliont capability | Employer Defense application |
|---|---|
| Answer-based routing | Leads that aren't submitted by an authorized employer representative are flagged separately from genuine employer defense matters. |
| Weighted scoring | Insurer denial or reservation of rights, an active dispute or hearing, and claim recency each add weight so contested, time-sensitive matters surface above routine questions. |
| Document capture | The intake collects insurer letters, hearing notices, and injury reports before the consultation, so the file is already assembled when the matter reaches your CRM. |
| CRM sync | Only matters that pass the employer-authorization, US-jurisdiction, and claim-existence checks get sent through to your CRM as qualified leads. |
Common employer defense lead scenarios
Insurer has reserved rights
The employer's carrier has denied coverage or said it may not defend the claim, and the business is already facing a hearing or investigation — this combination scores as high priority.
Fresh claim, clear details
The injury happened within the last three years and the caller already knows the employee's name and injury date, making the matter easy to open without back-and-forth.
Employee calls instead of employer
The person filling out the intake is the injured worker, not an authorized employer representative — the intake flags this as a mismatch for an employer defense practice.
Claim occurred outside the US
The alleged injury happened outside the United States, which the intake treats as a jurisdictional disqualifier for a domestic workers' comp defense matter.
Old claim, few details known
The dispute happened more than three years ago and the caller doesn't have the employee's name or injury date — the intake still routes it but flags it for a closer look before scheduling time.
Connect Cliont to your workflow
Send leads
HubSpot, HighLevel, Salesforce, JobNimbus
Book matters
Google Calendar, Outlook Calendar, Calendly
Notify your team
Email, SMS, Slack
Automate follow-up
Zapier, Webhooks, API
Simple, transparent pricing
Choose the plan that works for your business.
Professional
Unlimited intake forms and leads for your growing business.
- Unlimited intake forms
- Custom video greetings
- AI-powered voice bot
- English + Spanish support
- Automatic lead scoring
- Digital estimates & e-signatures
- Photo, video & file upload
- Advanced analytics dashboard
Pay Per Lead
Only pay when you receive a qualified lead.
- Unlimited intake forms
- Custom video greetings
- AI-powered voice bot
- English + Spanish support
- Automatic lead scoring
- Digital estimates & e-signatures
- Photo, video & file upload
- Charged only for submitted leads
More workers compensation intake templates
Employer Defense lead-intake FAQs
How does the intake tell apart an employer calling about a claim from the injured employee themselves?
The first question asks whether the contact is reaching out on behalf of the business as owner, manager, HR, or an authorized representative, so calls from the injured worker directly are flagged as a mismatch rather than treated as a defense lead.
What happens if the caller doesn't know the employee's name or the injury date yet?
The intake still records the matter, but a missing name or date lowers the score slightly since it usually means the business hasn't pulled its claim file together, which is worth knowing before you offer time.
Can the intake surface cases where the insurer has already denied coverage or reserved rights?
Yes, that question is asked directly, and a denial or reservation of rights raises the score because those matters usually need the employer to retain independent counsel rather than rely on carrier-appointed defense.
Does the intake screen out claims that happened outside the United States?
Yes, the jurisdiction question asks whether the injury occurred in the US, and a no answer marks the lead as outside scope for a domestic workers' comp defense practice.
Why does the intake ask whether the claim happened within the last three years?
Older claims may fall outside relevant statutes or procedural deadlines, so recency is weighted into the score to help you prioritize matters that are still actionable.
What documents get requested before the consultation is booked?
The intake asks the employer to upload any insurer correspondence, hearing or lawsuit notices, and the underlying injury report so you're reviewing the actual paperwork rather than a secondhand summary.
How is this different from the Denied Claim Appeals or Claim Filing and Administration intakes?
This intake is built around defending the employer against a claim, dispute, or insurer coverage issue, while Denied Claim Appeals and Claim Filing and Administration are built around the injured worker's side of the process.
Turn employer defense visitors into qualified cases
Give every employer defense visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book a consultation.