American Ombudsman Enterprises

Tips For Employers

Develop a Safety Program

Develop a safety program, if you do not already have one in place. Your insurer should be able to assist you with the development of a safety program. The Center to Protect Workers' Rights also provides material and assistance for establishing effective safety programs.

Safety awareness and an effective safety program can reduce the frequency and/or severity of injuries. Frequency and severity of injuries are cost drivers of workers' compensation insurance premium rates.

Seek Medical Attention

Always seek appropriate medical attention for your employees' work-related injuries. Aside from the obvious importance of timely medical attention, delays in providing medical treatment may exacerbate the extent of the injury and any claim awards.

Report the injury

Do not delay reporting the injury. Delays work against you. The time to investigate the circumstances involving the injury begins as soon as you are aware of the injury.

If insured, you are required by law to file a complete report of every work injury requiring medical treatment beyond first aid with your insurer.

If not insured, you are required by law to file a complete report of every work injury requiring medical treatment beyond first aid with the Department of Industrial Relations.

In cases involving serious injury, illness or death, you are required to immediately report the case to the Division of Occupational Safety and Health (OSHA).

File the Claim Form

The injured worker will need to file a claim with your insurer. You should have the claims forms on hand so that your employee is able to acquire the form, complete the form and return it to you. This last act initiates a 'claims clock', that ensures a timely resolution of the injured workers' claim.

Be sure to file the injury claim form with your insurance provider. This is an important and necessary step in the process. Filing the claim at the earliest opportunity will expedite settlement of the claim.

If a work injury claim is filed directly with your insurance company, the insurance company must notify you within 15 days.

Your Insurance Provider and Premiums

You have several rights with regard to your insurance carrier and the amount of your premium:

  • You can request a report on the amount of reserves established which are broken down according to estimated medical costs, vocational rehabilitation costs and other expenses.
  • You can recover premium increases in some instances where the cases are ultimately decided to be non-compensable.
  • You have the right to discuss with the insurer all elements of the claim file that affects your premium.
  • You have the right to copies of documents that affect your workers' compensation premium.

ADR Ombudsman

Remember, when you participate in our ADR programs, the Ombudsman is available to help you.

Do not hesitate to contact the Ombudsman that is assigned to the injury claim in question or regarding your workers' compensation program in general.

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