How to make a Workers Comp Claim

The new Workers Compensation laws say that you must notify your insurer within 2 days of being aware that one of your employees has had an injury.  You can usually do this by phone or fax. The insurer is then required to contact you within 3 days to help you arrange an injury management plan for the injured worker. If you fail to notify your insurer within 5 days you may also be required to pay the first weeks wages as an excess.

1. Documentation and information you need

  • You will need to have all of the details of the injury such as name of injured worker, contact numbers, address, details of their doctor, circumstances of the injury and any suitable duties you may be able to offer to assist recovery.  You will also need to know your workers compensation policy number.
  • You might  need to have fully completed Workers’ Compensation Claims forms, copies of which can be obtained from your insurer.
  • There are two forms, one completed by the employer and one completed by the injured worker.
  • If the injury occurred on a journey or was the result of a traffic accident, a Journey Claim form needs to be completed by the claimant as well.
  • If you have any doubt about the claim ring your insurer and talk to them confidentially.
  • The injured employee must nominate a Treating Doctor if it is a lost time injury and both you and the employee must cooperate with any early return to work initiatives.
  • Remember, you must have any claim related documentation to your insurer within seven days of you having received it.

2. Making payments

  • Please do not make any payments on a claim until your insurer has notified you. Insurers can generally get back to you within 48 hours of receiving your injury notification, so they shouldn’t keep you in the dark. In any case, the Provisional Liability requirements say that the insurer must start making payments within 7 calendar days of the injury notification.
  • Send all medical, hospital and pharmaceutical accounts to your insurer for payment. Do not pay them yourself, your insurer will reimburse the providers directly or your injured worker if necessary.

If you know a claim number, please indicate this on the accounts that you are forwarding to your insurer, as this will help them expedite the payment. Copies of  wages reimbursement sheets can be obtained by contacting your insurer.