How To Help Your Clients File a Workers’ Compensation Insurance Claim

By January 20, 2022 No Comments

Did your employee report a work-related injury or accident?

If so, you need to file a workers’ compensation claim within 48 hours of the incident.

Do you know how to file a workers’ compensation insurance claim?

If you don’t know, don’t worry!

Here’s a 5-step process you can use when filing a workers’ compensation claim.


5-Step Process to Filing a Workers’ Compensation Insurance Claim

Filing workers’ compensation claims can seem complicated if you’re new to them.

So, we’ve broken it down into 5 basic steps.

We believe these 5 steps can steer you through the claims process.

Since workers’ compensation policies and statutes vary be state, know your state’s regulations before you experience an incident that requires a claim.


1. Provide Employee with Proper Workers’ Compensation Paperwork

Once the employee reports an on-the-job incident, you can kickstart the claims process.

Have the injured employee complete any post-accident paperwork required by company policy.

This could include a written statement provided by the employee outlining the details of the accident, such as:

  • How the accident happened
  • Where the accident happened
  • hen the accident happened.

The injured employee should also list all injured body parts.


2. Perform an Accident Investigation

As an employer, you should perform an accident investigation to assist with determining any third-party negligence.

(READ MORE: View other responsibilities for employers have in workers' compensation cases!

If the accident involves machinery, it is important to have the machinery secured and placed out of use until it is properly inspected.

It is also important to obtain photographs of the machinery, if possible.

If the accident involves a motor vehicle collision, it is important to obtain any third-party insurance information, witness statements, police report, etc.

These things will assist the insurer with determining any subrogation potential.


3. Report Incident to Appropriate Parties

You should know that filing a claim isn’t an admission of fault.

It is essential to promptly report work-related accidents to your insurer.

The employer can do this by completing the Employers’ First Report of Injury.

Depending on the state where the business is, not promptly reporting the incident could result in penalties or fines.

When submitting the Employers’ First Report of Injury, double-check all the names, social security numbers, addresses, phone numbers, residences, etc., as missing information could cause delays in getting the claim processed.


4: What to Expect Next

Now you have submitted the workers’ compensation claim to your insurer, the claims handling process begins.

The claims process could involve site visits, documentation verification, obtaining witness statements, obtaining wage information, etc.

The insurer will also determine compensability of the claim.

Compensability will be based on all the facts of the case, provided information, and the state’s applicable workers’ compensation statutes.



5. Stay in Contact with your Workers’ Compensation Carrier and Employees

It is important to stay in contact with the insurance company and be alert to any changes or updates to the information you’ve reported.

It is also meaningful to keep in touch with your injured employee to make them aware that you’re concerned about their recovery.


Establish a Workers’ Compensation Return-To-Work Plan

As an employer, it is important to contact the injured employee and understand what they can do as “modified duty” so you can report this to your insurer.

This will also help you make appropriate arrangements for the employee when they return to work.

Sometimes, in the employee’s return-to-work plan, you may have to provide updated training to help the employee transition into the new role.



Filing a workers’ compensation claim can seem complicated

However, we believe these 5 steps will assist you through the claims process.

If you have questions about how to report a claim, contact an AIA professional. We’re ready and willing to help you find the answers you need.

The AIA Team

Author The AIA Team

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