![]() ![]() ![]() Your employees have the right to appeal a decision by filing a formal internal grievance. Complete the Form Online for Subrogation Issues.Complete the Form Online for Worker’s Compensation Issues.Call the Subrogation Department at 60 or 60.The employee and/or dependents must complete the questionnaire within 10 days of receipt or the claims related to the injury will be denied. Note: an employee and/or dependent whose claims have been flagged as a possible subrogation issue will be mailed an Injury Report Form asking for more information about the incident. A copy of the worker’s compensation carrier’s denial must be submitted along with notification of whether or not the member is appealing the denial. In all cases except worker’s compensation, we will process the related illness or injury claims according to covered benefits and then pursue the responsible party for a recovery of benefits paid.įor worker’s compensation cases, we will only consider payment of work-related illness or injury claims according to covered benefits when the worker’s compensation carrier has denied medical benefits. any disability benefit act or other employee benefit act.This includes – but is not limited to – claims for: Employees should notify us through our Customer Care Center immediately when they file any claim related to an illness or injury caused by a third party or if a third party is liable. ![]()
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