Workers’ Compensation Claims Handling Timelines The NARS Way – WC Claims Handling Timelines Action Item Due Date Comments The Unit Manager has 2 hours to reassign a new claim to a specialist. The UM is notified by Assignments UM will assign within 2 hours email, metric, and diary. The specialist shall close any claim that has reached closure maturity within 24 hours. The specialist shall zero all claim reserves out and shall document the reason for the file closure. Closures Within 24 hours The compensability rationale shall include a detailed explanation and must be thoroughly documented and well supported with all the following applicable components: AOE/COE, ER/EE relationship, going and coming rule, injury by accident, pre-existing condition, injury descriptions inconsistencies, employer level investigation, intoxication, proximate cause of injury any applicable case law or statute to support when necessary. The Loss Details tab of the tree must also be Document a file note and marked compensable, denied, or deferred Compensability complete C3 within 10 days decision. Initiate a coverage investigation within 1 business day from receipt All files should contain a “Coverage” note, Coverage of claim. Max 3 days. either confirming or disputing active coverage. NARS’ Best Practices were created by and for the internal use of NARS and are confidential, proprietary and trade secret documents protected by the Uniform Trade Secrets Act and applicable state/federal law. They may not be copied, distributed, or reproduced, in whole or in part, without NARS’ express prior written authorization. Unauthorized use or distribution may be subject to civil and/or criminal penalties.