North American Risk Services, Inc. Workers’ Compensation CLAIMS FILE DOCUMENTATION EXPECTATIONS 14-DAYS MEDICAL ONLY STATUS REPORT Expectation: Due by the 14th day from the date reported. Follow up with status report is expected every 60 days thereafter unless treatment warrants otherwise. If the injured worker did not lose time from work and we are paying medical bills only, the following can be used for a status report at all levels. It is a medical-only claim with no questions of validity from the insured or claim specialist. Once bills are processed, file will be closed. Target date: *If you are managing treatment, the expectation is to follow lost time guidelines for contacts and status reports. LITIGATION Expectation: Due by the 14th day from the date reported, if applicable. If no litigation, add upon receipt of attorney representation. Copy and paste the template into the file and fill it in. Example note for no attorney: This claim is not litigated at this time. The injured worker is not represented. If litigated: Plaintiff attorney is Defense attorney is If referred to counsel, the specialist is responsible for sending the file with a summary to defense counsel. Example file note: Received legal plan of action and budget from Defense Counsel. The budget is $25,000.00 and is set to include: deposition, etc. Defense counsel values this file at the present time in the range of 20-30% based upon the nature of the injury and the location of the injured worker. Suggestions for further workup include obtaining an IME and scheduling the injured worker’s deposition. Legal review with Muselman Law Firm. We discussed extending authority up to $25,000.00 as we are looking to resolve this Iowa claim with an Agreement for Settlement. Will follow up with defense counsel in two weeks to determine the status of settlement negotiations. *Complete Litigation Module – Send diary to CSR to add defense attorney to Bottomline/Legal X. Leaders are required to review the following and document a note to the file: • Hearing Notices • Settlement/Evaluations, as needed for training • CMS Liens 20 21