North American Risk Services, Inc. Workers’ Compensation CLAIMS FILE DOCUMENTATION EXPECTATIONS 14-DAYS COVERAGE Expectation: Due by the 14th day from the date reported. Copy and paste the template into the file and fill it in. Items to check or paste to the file if all apply: • Search and reload completed and coverage confirmed. • The policy number has been confirmed. • The loss did occur within the policy period, and the Jurisdiction is covered. • There has been no breach of any policy condition • No policy exclusions apply • No individual, corporation, or partnership considerations apply • There is no concurrent jurisdiction. • There is no deductible, or There is a deductible • Any reason to send a risk alert? Example Note: The injured worker is not covered under this policy as it is written only to cover clerical staff versus the trucking staff. Coverage has been verified upon review of the policy for workers’ compensation, as Green Electronics does have a current policy for all staff. The injured worker has been verified as an employee by Green Electronics. ***If no coverage, please state clearly why and next steps for the claim. INITIAL INJURED WORKER CONTACT Expectation: Due by the 14th day from the date reported. Copy and paste the template into the file and fill it in. Medical only Template: Called the injured worker and introduced myself as the contact for any future needs related to this workers’ compensation claim. Provided my contact information. Also sent a letter out. (Client Specific) Template: Claim does not warrant injured worker contact currently. It is a medical-only claim with no questions of validity from the insured or claim specialist. (Client Specific) Template: This is an incident-only claim, and per the client’s instructions, no contact was made with the injured worker. ***The following template includes essential questions. Please refer to your injured worker statement for a more thorough investigation. (see next page) continued on page 13 12 13