Report Requirements
EXCESS REPORTING REQUIREMENTS

Claims meeting certain criteria must be reported to Safety National immediately. This allows us to mobilize our resources to assist the employer and TPA in managing the case, and help ensure the injured worker receives appropriate treatment. The following injuries should be reported immediately:


  • Fatalities
  • Paraplegics and quadriplegics
  • Serious burns, defined as 2nd or 3rd degree burns involving 25% or more of the body
  • Brain injury
  • Spinal cord injury
  • Amputation of a major extremity
  • Any Occurrence which results in a serious injury to two or more Employees.
For claims that do not meet the criteria above, the reporting requirements vary by policy form issued. At minimum, claims must be reported to Safety National if their exposure exceeds, or is likely to exceed, fifty percent (50%) of the Self –Insured Retention. Additional reporting requirements may apply based on the policy. Please consult your excess policy form for the full reporting requirements.



Report Requirements
HOW TO REPORT A CLAIM

A first report should contain the information on the First Report form. It should also include pertinent file documents which will allow Safety National to evaluate the potential exposure on the claim.




First reports can be sent to Safety National via email, fax, or mail.

MAILING ADDRESS:
Safety National
1832 Schuetz Road
St Louis, MO 63146

FAX : 314-995-3897

EMAIL : first.report@safetynational.com


Report Requirements
HOW TO REQUEST FOR REIMBURSEMENT

Reimbursement requests are treated with high priority, and are usually processed the week they are received. Requests for reimbursement should be sent to the Safety National claims personnel responsible for the file (e.g Claims Analyst, etc). The reimbursement request should include one of the forms below completed fully and signed, along with a detailed payment listing and summary of all payments made on the claim by payment category (e.g. indemnity, medical, expense, etc.)



Report Requirements
CLAIMS FORMS


Report Requirements
MMSEA SCHIP REPORTING
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