Laserfiche WebLink
JiThe Hartford <br /> Reporting a Work-Related Injury is Time Sensitive! <br /> Call The Hartford's LossConnect immediately to report a claim. <br /> 1 -800-327-3636 <br /> Available 24 hours a day, 365 days a year. <br /> The Benefits of Timely Loss Reporting: <br /> Research has shown that faster foss reporting significantly affects loss costs. The sooner we are notified, the sooner we <br /> can investigate the accident and coordinate with you, the injured employee, and the medical team to ensure the fastest <br /> possible return to health and work. <br /> The Effect of Timely Reporting on Controlling the Cost of Your Loss: <br /> Average Loss for Closed Claims <br /> (Accident Years 2002-2005) <br /> Report Lag in Days Percent Change in Loss Costs <br /> Compared to First Week Report <br /> Incident Da -6% <br /> Week 1 0% <br /> Week 2 13% <br /> Week 3 or 4 16% <br /> 1 Month or Later 24% <br /> Statutory requirements also necessitate the prompt initial reporting of the accident causing <br /> injury or death. Failure to comply may result in a fineable offense by the State. <br /> Information You'll Need <br /> Company Information Incident Information <br /> o Account Number o Type of injury (burn, cut, etc.)? <br /> o Location Code (if applicable) o Exact body part injured? <br /> o Parent Company (or program name) o What caused the accident? <br /> o Policy Number o Any reason to question the injury? <br /> o Any witnesses? <br /> Worker Information o Address where injury occurred? <br /> o Name, DOB, Address, Phone o Where was the injured employee treated? (Provide <br /> o Social Security Number name, address, phone of medical provider.) <br /> o Age, Gender o When was the accident reported to you and by <br /> o Marital Status, Number of Dependants whom (date, time)? <br /> o Hire Date, Years in Current Position <br /> o Wage Information <br /> Network Providers <br /> A listing of more than 400,000 network providers qualified to treat work-related injuries is available online at <br /> www.talispoint.com/hartext or by calling our Network Referral Unit at 1-800-327-3636 (select 4 at the prompt). Since <br /> network referrals are often impacted by state specific rules, please tali to learn how to maximize our network capabilities <br /> on behalf of your employees. <br /> Form WC 66 03 84 Printed in U.S.A. <br />